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Varicocele is the most common identifiable pathology in infertile men. It is present in 15% of the male population, in approximately 35% of men with primary infertility and in 50% to 80% of men with secondary infertility. It is generally accepted that varicocele exerts a negative influence on spermatogenesis and steroidogenesis, primarily by elevating testicular temperature. However, the effect of varicocelectomy on the restoration of testicular function and fertility in adults is the subject of ongoing controversy. Microsurgical varicocelectomy has been advocated as the ‘gold standard’ method, based on the low complication rate associated with this procedure. In the era of advanced assisted reproduction, varicocelectomy is a valuable tool in the management of infertile men.