### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
How serious is a grade 1 subclinical varicoele? I m 35 years old, and I was just diagnosed with a grade 1 varicocele . Can a grade 1 varicocele affect fertility? My wife and I are trying to conceive. - my sperm count is 10 mil, but my motility and everything else are fine. Is my varicocele and low sperm count related? Why or why not? - about 5 years ago I experienced a dull ache in my testicles . It either eventually went away, or I just got used to it. After researching online (big mistake I know), I read that swollen varicoceles can cause this. Can a grade 1 varicocele cause this? I only ask because the ache only returned after I got the news. Is it all in my head? - can varicoceles get worse? over time, can it go from a grade 1 to a grade 3? Can grade 1 develop to the worm stage? - if the ache does not go away, should I consider surgery? Would that help my fertility chances as well?

### output:

Hi, Welcome to Chat Doctor It is true to say that varicocele, as it increases the local temperature of testes, may affect sperm production and surgery of varicocele is very commonly offered in subfertility. But in your case, it is better to rule out any other cause of infertility in yours pose and yourself as a 10 million count of sperm with a normal motile is OK for a fertility and many times even after surgery if fertility is not ensured, it may require IVF. Also, a subclinical varicocele or a grade 1 varicocele is more like to be just incidentally related to low sperms rather than having a cause and effect relationship. The only other indication of surgery is a pain due to which you are mentally and physically suffering in your daily routine and which is not subsiding with scrotal support and occasional analgesics. The recurrence rate after surgery is pretty high as there are so many veins to recur. In short surgery is not for a case like you. Also, even if there may be risk of increase in size of varicocele with time, surgery now or later is exactly the same. Relax, take care