Reconsidering vasectomy reversal over assisted reproduction in older couples

Vasectomy reversal should be strongly considered in men with a partner aged 40 years. Vasectomy reversal can be considered in carefully selected patients even with a partner aged >40 years.

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Volume 109, Issue 6, Pages 1020–1024

Authors:

Akash A. Kapadia, M.D., Marcus Anthony, B.Sc., Ann Martinez Acevedo, M.P.H., Eugene F. Fuchs, M.D., Jason C. Hedges, M.D., Ph.D., Kevin A. Ostrowski, M.D

Abstract:

Objective

To provide pregnancy and live birth rates from a contemporary series of vasectomy reversals in men with female partners aged ≥35 years and to correlate the results with IVF.

Setting

Tertiary academic referral center.

Design

Retrospective comparative study of prospectively collected database.

Patient(s)

Two hundred forty-six men who underwent vasectomy reversal for fertility with female partner aged ≥35 years.

Intervention(s)

Vasovasostomy or vasoepididymostomy.

Main Outcome Measure(s)

Correlation of pregnancy and live birth rate of this cohort by age groups with most recently published pregnancy and live birth rate per IVF cycle.

Result(s)

One hundred thirty-six men who underwent vasectomy reversal between 2006 and 2014 met our inclusion criteria. Overall pregnancy and live birth rates were 35% and 30%, respectively. Subgroup analysis by female age groups (35–37, 38–40, >40 years) demonstrated pregnancy and live birth rates comparable to those per IVF cycle by age groups according to a recently published (2015) national report.

Conclusion(s)

Vasectomy reversal should be strongly considered in men with a partner aged ≤40 years. Additionally, vasectomy reversal can be considered in carefully selected patients even with a partner aged >40 years.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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