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Consultant urologist Dr George Lee Eng Geap, or a.k.a Dr G, advises a reader what he can do when he found out that his scrotum is warmer than normal and his sperm count is low.

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Transcript
00:00For this week, we are going to talk about varicocele and how the reversal of varicocele
00:07can potentially enhance a man's fertility.
00:17Varicocele actually is a dilated vein inside the actual testicle itself and then that itself
00:25might just be similar to the dilated vein in the varicose vein on the lower limbs of somebody.
00:31Actually, nobody knows why it happens but it can happen between 15 to 20% of general population
00:38without knowing about it. Sometimes that itself might cause a little bit of discomfort and most
00:44men actually are quite oblivious of that discomfort is caused by varicocele. Sometimes it can be a
00:50bit unsightly because it looks like bag of worms in there but what this extra form of
00:57dilated vessels or dilated vein in the testicle has an impact on the spermatogenesis because it will
01:05increase the temperature in the scrotum by nearly one degree and that itself will have an adverse
01:12impact on spermatogenesis. So men with varicocele is noted to have lower quality of sperm by lower count
01:20and lower morphology of a normal sperm and lower motility. So a combination of all these is known as
01:29oligo-asteno-teratospermia. So when men presented to fertility clinic and noted to have oligo-asteno-teratospermia,
01:42then we check the varicocele. If it's noted to be dilated, then an operation to reverse it might be
01:50useful. The operation can be done as open procedure or microscopic procedure or laparoscopic procedure
01:56and all these are to shrink the dilation and make the testicle cooler for spermatogenesis.
02:04It's well proven to increase the number, morphology and motility. Does it translate to lipid? The answer
02:13is yes. According to Cochrane review, it actually shows that it increases the pregnancy rate by at least
02:20one in seven couples who are trying for the pregnancy and that translates to enhancement of at least 20 to
02:2925 percent of live pregnancy. So is there any drawback of such intervention? Well obviously the operation
02:37itself sometimes may cause a bit of bleeding and a bit of infection but those are quite minor. But the
02:43biggest headache is that such intervention always may come back in the future so some men may need to do
02:51it several times in order to enhance their sperm quality. But the best thing to do actually is stay
02:57healthy, exercise regularly, eat healthy food and that itself will simultaneously enhance sperm quality
03:04and enhance the chances of you getting pregnant. So for the second week of July, we're going to talk
03:11about how to enhance sperm quality and what sort of food is well known to enhance sperm quality.
03:17Stay tuned for next week's Putting Dr. G on the Spot.
03:27you

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