<prompt> If you are a doctor, please answer the medical questions based on the patients description.i am male 28,on my infertility work up diagnosed with bilateral grade 2 vericocele, i had semen analysis 4 to 5 times. at first 40 million motility normal after sperm count deceasing to 25, 15, 20, 05 in further tests with all normal motility. i have no stress and psychological problems, all my harmonal reports lh,fsh,TT,TF, prolactin are normal but having elevated E2 is 92.29 pgml, having good erections but suffering low libido and no that much plesure in intercouse and while ejaculating. what to i do now doctor suggested surgery for vericocele is it required for bi lateral grade 2?  <response>: Hello and welcome to Chat Doctor. As a Urologist, i can understand your anxiety. Surgery for varicocele, isnt guaranteed to reverse your low sperm counts. Your semen analysis, showed decreasing counts of 25 to 5 millionml. With normal hormonal levels, you should consider ART.ART is assisted reproductive techniques, like GUI intrauterine insemination, or CSI, whichs a type of IVF invited fertilization, or test tube baby. Medical treatment with camphene citrate, Co-Q and lycopenes needed. If youve any doubts, send all reports to me, as a direct question. Chat Doctor. Manga. 