Vasectomy reversal performed 15 years or more after vasectomy: correlation of pregnancy outcome with partner age and with pregnancy results of in vitro fertilization with intracytoplasmic sperm injection

Objective: To document a contemporary series of vasectomy reversals performed in men 15 years or more after vasectomy and to correlate the results with spousal age and results of ICSI for obstructive azoospermia. Setting: University referral center for male infertility. Design: Retrospective analysis of a single surgeon's experience compared with reported ICSI results. Participant(s): One hundred seventy-three men who had vasectomy reversal 15 years or more after vasectomy. Intervention(s): Reversal of vasectomy by vasovasostomy or epididymovasostomy. Main Outcome Measure(s): Correlation of pregnancy results after vasectomy reversal with spousal age and published ICSI results. Result(s): Pregnancy rates for the intervals of 15-19 years, 20-25 years, and >25 years after vasectomy were 49%, 39%, and 25%, respectively. For spousal age <30 years, 30-35 years, 36-40 years, and >40 years, pregnancy rates were 64%, 49%, 32%, and 28%, respectively. The overall pregnancy rate was 43%, which is similar to the pregnancy rate of 40% for ICSI in obstructive azoospermia. Sixty-two percent of the men required a unilateral or bilateral epididymovasostomy. Conclusion(s): Spousal age is an important predictive factor after vasectomy reversal among men who have C reversal 15 years or more after vasectomy, pregnancy rates after vasectomy reversal compare favorably with those obtained with ICSL (Fertil Steril((R)) 2002;77:516-9. (C) 2002 by American Society for Reproductive Medicine).