Semen quality and partner pregnancy rates are favorable among men who have a vasectomy reversal at least 10 years after the original procedure, new research suggests.
"Although the VOI [vasal obstructive interval] has a significant effect on the type of VR [vasectomy reversal] required, provided a surgeon is proficient with both vasovasostomy and vasoepididymostomy, favorable semen parameters and patency and pregnancy rates can be achieved in men with a VOI [of more than] 10 years. Couples should not be discouraged from considering VR solely because of the VOI," wrote Dr. Ethan D. Grober of Mount Sinai and Women’s College Hospital, Toronto, and his associates.
The research, published in Urology (2014;83:320-3), examined the postoperative semen parameters, patency rates, and partner pregnancy outcomes of 535 men, 177 (or 33%) of whom had VOIs of more than 10 years. The patients were divided into four groups based on VOI duration: less than 10 years, 10-15 years, 15-20 years, and more than 20 years.
Partner pregnancy rates among men with a VOI of more than 10 years ranged from 24% to 39%, compared with 43% when the VOI was less than 10 years. Differences in pregnancy rates between age groups were likely influenced by factors such as age, reproductive health status, type of procedure, and overall sperm quality after surgery.
Patients underwent a vasovasostomy, a vasoepididymostomy, or a complete vasectomy reversal, with similar surgical techniques used for each procedure. Patency rates were around 90% for patients with a VOI of less than 10 years, compared with 87-92% for those with a VOI of 10-19 years.
Mean sperm counts were not significantly different among the four groups when stratified by the VOI. Mean postoperative counts of more than 20 million sperm per milliliter were achieved in all groups after VR, irrespective of the VOI. The percentage of motile sperm decreased (ranging from 38% to 21%) and the percentage of normal morphology showed a trend toward a decrease as the VOI increased.
The investigators declared that had no relevant financial interests.