We perform vasectomy reversals.

Microsurgical vasovasostomy(VVS) is the standard method for vasectomy reversal. In a recent article, Heidenreich, et. al (European Urology 2000; 37:609-614) compared 112 cases of VVS with 69 cases of microsurgical epididymal sperm aspiration/testicular extraction of sperm (MESA/TESE) with intracytoplasmic sperm injection (ICSI) with respect to efficacy, costs, and complication rates. Self-administered questionnaires were used for follow-up. Patency and pregnancy rates were 77% and 52%, respectively in the VVS group. Complications occurred in 4.7% of men. In couples who had MESA/TESE with ICSI, the pregnancy rate was 24.5%; the abortion rate was 15.8%. Differences in pregnancy rate were statistically significant (P<000.2). Complications occurred in 3.9% of men and 7.1% of women. The multiple gestation rate was 15.8% vs. 1.2% in the VVS group. Based on these findings, the total delivery cost for VVS was significantly less than for the MESA/TESE with ICSI (P<0001).

VVS is the best option for vasectomy reversal based upon higher pregnancy rates, less complications, and significantly less cost

 

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Male Infertility