Microsurgical Varicocelectomy Versus No Surgery in Men With a Palpable Varicocele and an Abnormal Semen Analysis

Inclusion Criteria: * 6 months of infertility (primary or secondary - randomization will be stratified to allow equal numbers of primary and secondary infertility couples in the treatment vs. observation group), male partner \> 18 years of age and \< 50 years of age * Female partner \> 18 years of age and \<= 40 years of age - randomization will be stratified for two groups - female partner \<35 and female partner \>=35 * Evidence of a hysterosalpingogram or Saline Infusion Sonogram with one patent tube and regular ovulatory cycles as defined by the recruiting site \>25 days and \<35 days in duration in the female partner * Evidence of a bilateral grade I or unilateral grade II-III varicocele on physical exam in the male partner * Abnormal semen analysis as defined by WHO II criteria with a sperm count of \>5 X106 /ml or the presence of abnormal strict morphology as defined by Kruger criteria. Exclusion Criteria: * The presence of retrograde ejaculation or uncorrectable ejaculatory dysfunction * Decreased ovarian reserve in the female partner as evidence by a day #3 FSH \> 12 mIU/ml