Pregnancy after vasectomy: surgical reversal or assisted reproduction?

This study was a retrospective single-center cohort analysis of all males with a vasectomy in the past seeking treatment between 2006 and 2011 (n = 163). One group of patients opted for a reanastomosis procedure while the others opted for an immediate IVF/ICSI treatment. This included 99 males who underwent reanastomosis and 64 couples who immediately underwent ICSI treatment.PARTICIPANTS/MATERIALS, SETTING, METHODSAll reanastomosis procedures were done by the same surgeon. ICSI was used in all cases where testicular sperm were extracted by fine needle aspiration (FNA) or testicular sperm extraction (TESE).MAIN RESULTS AND THE ROLE OF CHANCEThe mean male age at vasectomy was 35.5 years and 44.4 years at reanastomosis. The mean (range) obstructive interval was 9.53 years (1 –27). No significant differences were found between the two groups in female patient characteristics, such as age and parity. In the reversal group, the crude cumulative delivery rate (CDR) was 49.5%. However, in the 45 patients of this group who attempted to conceive spontaneously (‘primary rea nastomosis’ pathway), the crude CDR was 40.0%. The remaining 54 patients (the ‘switchers’ pathway) who underwent a reversal procedure and later switched to ART, had a crude CDR of 57.4%. Of these, four patients opted for insemination, including two who later decided to switch to IVF/ICSI. The 64 patients who immediately underwent IVF/ICSI (‘primary IVF/ICSI’ pathway) had a crude CDR of 43.8% and an exp...
Source: Human Reproduction - Category: Reproduction Medicine Source Type: research