Clear indications to repair a varicocele in adolescence include progressive testicular atrophy, pain, or abnormal semen analysis results. Although the treatment of a varicocele generally improves sperm characteristics, it is not clear if an untreated varicocele leads to progressive worsening of sperm quality over time.
In general, varicocele treatment might not be necessary. Many men with varicoceles are able to father a child without any treatment. However, if a varicocele causes pain, testicular atrophy, infertility, or if assisted reproductive techniques are being considered, varicocele repair could be needed.