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Two reports from physician-scientists at NewYork-Presbyterian Hospital/Weill Cornell Medical Center shed new light on male infertility. A first report shows that a common cause of male infertility—varicoceles, or varicose veins in the scrotum—also results in a depletion of testosterone. In a second related finding, researchers demonstrate that once a common, simple surgery is used to treat varicoceles and thereby restore fertility, testosterone levels are also improved.

Dr. Marc Goldstein, Professor of Urology and Reproductive Medicine at Weill Cornell Medical College and surgeon-in-chief, male reproductive medicine and surgery, at NewYork-Presbyterian/Weill Cornell, presented his novel research, along with lead author Dr. Cori Tanrikut, former fellow and current adjunct assistant professor at Weill Cornell, at the 2007 annual meeting of the American Society for Reproductive Medicine (ASRM) in Washington, D.C.

"People often forget or often don't realize that the testes have two purposes," says Dr. Goldstein, who was also awarded the prestigious Howard and Georgeanna Jones Life Time Achievement Award by The American Fertility Association. "One is the production of the sex cells (sperm), and the other is to produce testosterone."

In his research, Dr. Goldstein hypothesized, and later found that, the presence of varicoceles causes significantly lower testosterone levels. He also observed that following varicocele removal, testosterone levels are greatly improved in more than two-thirds of the men studied.

With impaired testosterone production, males may experience andropause, analogous to menopause (lowered estrogen levels) in women. A man may have a lowered sex drive, the inability to have erections, lowered muscle strength and energy level, and even depression. Also, affected men are more prone to osteopenia and osteoporosis, causing weakened bones.

Testosterone production is lowered by the varicoceles—enlarged and twisted veins wrapped around the male testis. The condition can be hereditary and is found in 15 percent of all males; it also leads to a lowered sperm count and quality.

Thirty-five percent of all cases of primary infertility (first pregnancy attempt) and 80-percent of secondary infertility (attempts at pregnancy following a successful impregnation) are due to varicoceles.

Dr. Goldstein, a pioneer in urology surgery, helped to invent the microsurgery procedure now considered the standard in the treatment and removal of varicoceles.

Varicoceles begin forming at puberty and most doctors do not screen patients during routine check-ups.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center

NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and its academic partner, Weill Cornell Medical College. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian, which is ranked sixth on U.S.News & World Report's list of top hospitals, also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center.