Implications of Human Chorionic Gonadotropin (hCG) Therapy in a Varicocele Patient and Its Effect on In Vitro Fertilization (IVF) Outcome

This case study pertains to a 32-year-old male and a 29-year-old female who sought treatment at a fertility clinic due to their primary infertility, which had persisted for over four years. Both individuals underwent comprehensive physical and hormonal examinations; while all reports for the female partner indicated normal findings, the test reports for the male partner revealed the presence of azoospermia and varicocele. The standard surgical protocol for varicocelectomy was followed. However, no improvement in the semen parameters was observed. Subsequently, microsurgical testicular sperm extraction was performed on the male patient in an attempt to retrieve sperm from testicular tissues, but the outcomes were negative. In response to these findings, the patient was advised to undergo intramuscular injections of human chorionic gonadotropin (hCG) at a dosage of 3,000 IU on alternate days, in conjunction with the daily administration of clomiphene citrate at 30 mg. Improvement in sperm parameters was seen after six months, leading to the successful intracytoplasmic sperm injection and the development of six blastocysts. The use of hCG significantly improved the semen quality, and frozen embryo transfer resulted in clinical pregnancy after endometrial preparation, highlighting the utilization of hCG therapy in varicocele cases for enhanced sperm retrieval and pregnancy success.