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Varicoceles, an enlargement of the veins of the spermatic cord, are the most common identifiable and correctable cause of male infertility. A new study by physician-scientists at NewYork-Presbyterian Hospital/Weill Cornell Medical Center suggests that fathers, sons, and especially brothers of men with varicoceles are at greater risk for varicoceles themselves. Published recently in the journal Urology, the study is the first ever to shed light on the inheritance patterns of this condition.

Of the 63 first-degree relatives of patients with known varicoceles, 35 (56.5%) had clinically palpable varicoceles on physical examination; this was significantly greater than the 18 (6.8%) of 263 first-degree relatives in the control group of men without varicoceles. Among first-degree relatives of men with known varicoceles, 20 (74%) of 27 brothers, 13 (41%) of 32 fathers, and 2 (67%) of 3 sons had palpable varicoceles.

"Since early repair of varicoceles may prevent both future infertility and hormone deficiency, given our findings, I recommend that first-degree relatives – particularly brothers – of men with varicoceles be examined for varicoceles," says Dr. Marc Goldstein, the study's principal investigator, surgeon-in-chief of male reproductive medicine and surgery at NewYork-Presbyterian/Weill Cornell, and professor of reproductive medicine and urology at Weill Medical College of Cornell University. "Patients should be counseled about this increased risk for their male family members."

Dr. Goldstein pioneered a minimally invasive microsurgical approach to removing varicoceles in the 1980s. That approach is the standard treatment today.

Varicoceles are detected in approximately 15 percent of the general male population, with the prevalence increasing to 35 percent of men presenting with primary infertility, and up to 80 percent of men with secondary infertility. The condition is also a possible risk factor for lower testosterone levels, which could lead to premature symptoms of testosterone deficiency when men are older.