If there are physical problems such as varioceles (abnormal enlargement of a vein in the scrotum) and ejaculatory duct obstruction then these can often be resolved through micro-surgery. If your GP hasn’t checked for any of these you may wish to ask for this to be done. We have had at least one couple who had been trying to conceive for several years and despite poor sperm results there had been no further investigations. It is was through self-referral to a urologist that a large variocele was discovered and removed, and 3 months later the man’s sperm test was perfect.
The most common symptom of a varicocele is a dull, constant ache or persistent sensation of heaviness in the testicle. Some men say the problem is most noticeable when they have been standing for a prolonged period. Often, the discomfort is minimal in the morning, but increases toward the end of the day, and the pain may diminish on lying down.