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מכון שלזינגר לחקר הרפואה על פי ההלכה

Varicocele follow up question – continueing #5769

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24 ביוני 2011

הרב המשיב: אחר

שאלה:

1.
Hi

Thanks for the below analysis.  This is the new question I have:

I am not married.  I am 29 years old.  I have a varicocele for sure.  We don't know whether the varicocele has caused low sperm as I haven't done a test for it.  However, my testosterone is low and according to many that may be caused by varicocele.  However one can't know for sure, a sperm count test will probably verify whether the cause of low testostrone is varicocele or something else.

Q1  Would it be allowed to do the sperm test even if one is not maried and the fertility is not an issue if it is recommended by a doctor to confirm the caues of another condition ?

Q2  If the answer is yes and the test shows a low sperm count, can a varicocele emobilzation be done to fix a low testostrone when fertility is not an issue at this point but may possibly be later on ??

Q3  If the answer is yes and the test shows a good sperm count, can a varicocele embolization be done to fix a low testostrone ?

Thanks


2.
Hi
 
Can you please help to poskin on below request urgently.
 
2 other factors have came to light as well.  A varicocele can cause low sperm count and if not treated then can cause more damage in the long run.  Per the doctor, the semen test below will a) confirm whether varicocele is having an effect on sperm b) whether varicocele is the cause of low testosterone.  This result will indicate that the varicocele might need to be treated in order to resolve both a & b and avoid additional fertility issues in the future.
 
Please advise whether it would be permissible to to get semen test and below questions.
Your kind response will be greatly appreciated.
Thanks very much

תשובה:

Shalom,

A2-3  Regarding the second and third question, varicocele embolization is halachically permitted regardless of whether there is fertility issue. The medical advisability of such a procedure should be addressed to the attending physician.

A1  Regarding the first question (and the follow-up question), there is no prohibition to conduct a sperm count when done for the purpose of fertility.

However, it is generally not advisable to perform this test for unmarried men with varicocle. This is because such a test is liable, in practice, to reduce the chances of the person getting married and having children, for the following reason:

Most people with varicocele are fertile (although the incidence of varicocele is higher in infertile men than in fertile men). The medical concensus now is that varicocele leads to a gradual decrease in fertility. Therefore, it is advisable for men with varicocele not to delay marriage, even if this requires a "mental switch," and there is usually no need to disclose to the prospective fiancée that he has a varicocele. His chances of being a father in a short time are high, in most situations.

However, if a sperm count is done and it shows that there is a compromised fertility issue, this result may require disclosure to the potential fiancée. This situation can sometimes delay greatly, or even prevent, the possibility of the man marrying in the future. Therefore, if he marries earlier with the expectation that there is a good chance that he is fertile, his family status is better on all accounts.

If the person gets married and there prove to be difficulties conceiving, it is recommended to perform the recommended fertility tests then, and to treat as necessary.

It is recommended to raise this point with the physician before making a decision about the sperm count.

For additional sources on this topic, see Question 5495.
We will try to address your additional points in the coming week.
Best Wishes,
Meir Orlian

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