Grade I Classification of Varicocele

In this category, the dysfunctional veins are not visible. A doctor detects them during a physical exam while the patient performs a [medical term alert] Valsalva maneuver. A Valsalva maneuver is a breathing exercise used as a diagnostic tool.

Grade II Classification of Varicocele

Varicoceles in this grade are still not visible, but can be felt during a doctor’s exam even without the aid of a Valsalva maneuver.

Grade III Classification of Varicocele

In this category, the varicoceles can be easily identified through the scrotum; there is no need to perform a physical exam to detect them.^[ii]

There are ongoing studies reviewing the link between the size of the varicocele as determine by varicocele grading and infertility. Prior studies have shown links related to the various varicocele types and grades and infertility in men, including the effects on sperm count, movement, and quality. According to those studies:

• The raised temperature in the scrotum caused by varicocele leads to lower sperm counts.
• Varicocele can cause damaged sperm and also creates an environment in the body where sperm do not thrive, therefore they do not move or function as well as healthy sperm.
• Sperm quality decrease is correlated with the higher grades of varicocele.
• The primary difference in semen quality among the three groups is that those with Grade III varicocele more often had a low sperm count (oligospermia) and decreased sperm motility than those in the other groups.