This report identifies a rare case of a young male with oligospermia who is found to have congenital fusion of the spermatic cords, left unilateral seminal vesicle agenesis, as well as a left grade III varicocele. Workup established a lack of cystic fibrosis transmembrane conductance regulator (CFTR) mutation or urinary abnormalities usually associated with male anatomical reproductive alterations. A unilateral seminal vesicle agenesis is exceedingly rare and may lead to both obstructive and nonobstructive subfertility. The gene discussed is CFTR; the disease is varicocele.