Oligoastenospermia grave 45 anni

Salve, ho 45 anni e per la prima volta, incalzato dalla mia compagna, ho fatto uno spermiogramma con il seguente esito:
-colore grigiastro
-consistenza fluida
-ph 7.4
-volume 1,5 ml
-n. spermatozoi 30.000.000 /ml
-n. Cell. rotonde 100
-motilità 100% immobili
-morfologia 35% di forme normali e 65% forme anormali
-spermatociti 2 - spermatidi 2
-leucociti 6
All'eco doppler scrotale risulta un varicocele di 3 grado secondo Sarteschi.
M'è stata prescritta una cura di almeno due mesi con Spergin Q10.
So che alla mia età può essere inutile trattare il varicocele.
Che possibilità ho (se ne ho!) di migliorare la mia situazione e con quale terapia?
In attesa di un vostro gentile riscontro invio un cordiale saluto e buon lavoro.
[#1]
Dr. Mario De Siati Urologo, Andrologo 2.9k 86 1
The significance of age on success of surgery for patients with varicocele.
Int Urol Nephrol. 2010; 42(2):351-6 (ISSN: 1573-2584)

Reşorlu B; Kara C; Sahin E; Unsal A
Kecioren Training and Research Hospital, Ankara, Turkey. drberkan79@gmail.com

OBJECTIVES: The aim of our study was to assess the impact of patient age on sperm characteristics, and hormonal levels following varicocelectomy. METHODS: We retrospectively reviewed the clinical records of 96 patients with a mean age of 28.1 years (range 18-48), who underwent microsurgical subinguinal varicocelectomy because of infertility, palpable swelling, or scrotal pain. These groups of patients were categorized into three age groups: group I, 18-25 years old at the time of varicocelectomy (n = 35 [36.5%]); group II, 26-35 years old (n = 43 [44.8%]); and group III, older than 36 years (n = 18 [18.8%]). RESULTS: Of the 96 patients, 68 attended the initial postoperative visit at 1 month and 96 attended the 6 months follow-up visit. Before surgery, no significant differences were seen among the three groups in sperm concentration, sperm motility and hormonal levels. After ligation, the sperm concentration and motility rates increased in all groups, but no significant differences were seen among the three groups for those parameters (P = 0.235 and P = 0.729, respectively). However, no significant changes in follicle-stimulating hormone, LH, testosterone levels were observed between each group. At sixth month of follow-up, two patients in group II, and a patient in group III, had persistent scrotal pain, and a patient in group I had varicocele recurrence; but no patients had hydrocele formation, evidence of testicular loss or progressive hypotrophy. CONCLUSIONS: The results of our study have shown that age is not a significant factor for outcomes of surgery and subinguinal microsurgical varicocelectomy in all aged patients has a similar high success rates.
Tenuto conto che non ci sono molte alternative , personalmente tenterei la strada dell'intervento di correzione del varicocele . Cordiali saluti

Dott. Mario De Siati Urologo-Andrologo esercita a Foggia,Taranto,Altamura (Bari),Brindisi