Received August 17, 2026
Accepted September 04, 2026

Varicocele remains the most common correctable cause of male infertility and one of the few male-factor conditions in which targeted intervention may improve both sperm quality and reproductive outcomes. The role of varicocele repair has increasingly been challenged by the widespread dissemination of health misinformation through digital platforms. Simplified narratives frequently suggest that assisted reproductive technologies (ART) have rendered surgical correction obsolete, that varicocelectomy carries significant risk, or that its impact on fertility is minimal. These claims are not supported by contemporary evidence. Microsurgical varicocelectomy is associated with a favorable safety profile, including low recurrence rates, minimal hydrocele formation, and an exceptionally low risk of ischemic testicular injury when performed by experienced surgeons. In appropriately selected men with clinical varicocele, infertility, and abnormal semen parameters or elevated sperm DNA fragmentation, repair leads to improvements in sperm concentration, motility, total motile sperm count, and genomic integrity. These biological changes translate into higher spontaneous pregnancy and live birth rates, as well as improved outcomes in ART. Varicocelectomy may reduce the need for more invasive and costly reproductive interventions, reinforcing its role as a fertility optimization strategy rather than a competing alternative to ART. The persistence of misinformation highlights the need for critical appraisal and synthesis of the available evidence. This expert opinion provides a comprehensive, pathophysiologically grounded, and quantitatively supported reappraisal of microsurgical varicocelectomy in modern male infertility care, while addressing the impact of health misinformation in the digital era and emphasizing the role of the urologist in evidence-based patient counseling.