Varicocoele is present in 15% of men. Patients suspected of having underlying malignant pathology or with significant discomfort from a large varicocoele should be referred for specialist review. The data regarding the relationship between the condition and infertility is inconclusive. NICE does not recommend surgical treatment of varicocoele for infertility. Patients or couples with infertility should be referred to a urologist with a specialist interest in fertility and an expert in assisted reproduction techniques, ideally to be seen in a joint clinic.