New child wish after vasectomy: vasovasostomy or assisted reproductive medicine? In the case of a new child wish after vasectomy, there are two options: vaso-vasostomy (VV) or biopsy of the testicle associated with intra-cytoplasmatic sperm injection (ICSI). Both methods are not reimbursed. The VV offers a cumulative pregnancy rate of 28-40%, depending on pre-, intra- and postoperative factors. The age of the female partner and the time after vasectomy are the most important factors. Pregnancy rates after ICSI are 29-41% per transfer. Cumulative pregnancy rates vary between 60-80%. Malformation rates after ICSI in this special collective are not investigated yet, the "general" ICSI-collective differs completely compared to the a priori fertile couples after vasectomy. Couples have to inform themselves about the experience of the doctors and their rate of success in order to minimize the risk of failure.
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Urology
January 2025
Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH.
Objectives: To determine if routine pre-vasectomy sperm cryopreservation is more cost-effective than fertility restoration for patients who desire additional children following vasectomy?
Methods: A scoping review was performed to collect published data regarding efficacy and outcomes of cryopreservation, vasectomy reversal, surgical sperm retrieval, and assisted reproductive technologies (ART). Cost data were collected from US-based facilities performing cryopreservation and andrology clinical care. A cost-effectiveness model was generated using TreeAge Pro cost-effectiveness modeling software with three different variations representing a balanced scenario with median expected parameter values, a scenario with assumptions/variables favoring pre-vasectomy cryopreservation, and a scenario favoring fertility restoration.
JAMA Netw Open
January 2025
Department of Surgery, Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
Rev Int Androl
December 2024
Urology Department, Hospital Center Vila Nova de Gaia and Espinho, 4405-843 Vila Nova de Gaia, Portugal.
Background: Vasectomy reversal (VR) is the only technique that allows men previously submitted to a vasectomy to conceive by natural pregnancy. We report our experience with microsurgical VR and identify predictive factors of natural pregnancy.
Methods: We retrospectively reviewed all patients submitted to VR by a single surgeon from 2008 to 2021 at our single center.
Cureus
October 2024
Obstetrics, Orlando Regional Medical Center, Orlando, USA.
Vasectomy is a permanent and safe method of male contraception. One commonly used definition of success is azoospermia in one or two semen analyses after 20 ejaculates after three months. Failure is higher if less than 1.
View Article and Find Full Text PDFIndian J Urol
October 2024
Department of Urology, New York University Langone Hospital Long Island, Mineola, NY, USA.
Introduction: Individuals choose to undergo vasectomy reversal for a variety of reasons, including remarriage or due to the death of a child. To be proficient in this procedure, the surgeons need to be high volume and the trainees require a safe environment to develop their microsurgical skills. To overcome this challenge, we used three-dimensional (3D) printing to create a synthetic model of the vas deferens with properties similar to the human vas deferens.
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