which involved seven andrological centers. The files of 2223 patients who underwent subinguinal ligation of a high grade left varicocele for [oligo] +/- [astheno] +/- [terato] -spermia and infertility between January 1 [st] , 2002 and January 1 [st] 2013 were reviewed. Inclusion criteria for the patients were the following: Sperm count improvement and fathering a child after an uneventful left varicocelectomy; 745 patients were considered. Patients who had undergone three assessments for [in-] fertility: Before surgery, before the first fathering and after the first fathering were included in the study. Each assessment included: Clinical history, physical examination, two sperm analyses, bilateral scrotal Duplex scans, blood hormonal levels [follicle stimulating hormone [FSH] , luteinising hormone [LH] , testosterone [T] and prolactin [PRL] . Forty patients were finally studied; they all had an improved sperm count and had fathered once after surgery. Fifteen had fathered twice and still had their sperm count increased after the second fathering. Twenty-five patients could not father twice; 13 patients had their sperm count decreased after the first fathering and 12 did not. A decrease in testicular volume and an increase in FSH paralleled the worsening of sperm concentration, motility and morphology after fathering. No other differences could be observed between the groups. Our data indicated that the beneficial effects of a varicocelectomy might be transitory in some cases