[The sociological approach to vasectomized patient trajectories at the Buenos Aires University Clinical Hospital "José de San Martín"].

According to the Argentinian Ministry of Health records the number of patients requesting vasectomy increased twelve times in public hospitals in 2015-2019. The physicians and specialists account for this change in recent years, arguing, among other reasons, cultural change when male assumes active position in contraceptive methods. The article addresses vasectomized patient trajectory at the Buenos Aires University Clinical Hospital "José de San Martín". The purpose of the study was to define from sociological point of view if we are actually witnessing cultural change. While considering last ten years (2012-2022), through diachronic analysis of patient demand at the Male Fertility Laboratory (n=1136) it was found that although main motivation is fertility, minority (6%) consulting to confirm absence of sperm in the ejaculate following vasectomy increased significantly in 2022 (Pearson's chi-squared test p<0.0001). After qualitative/quantitative interviews of former patient group (n=36) two sub-populations were distinguished: childless (42%; Median age: 30 years old; range: 24-35) and those having a family (58%; Median age: 39 years old; range: 35-54). Most of them had University degree (67%) and learned about this anti-contraceptive method by the Internet. It is remarkable that 94% of them were not aware of the the Argentinian Law № 236139 of 2006 that grants their right to vasectomy. Among all patients randomly interviewed in 2022 (n=200) condom anti-contraceptive method was the best known (67%). The conclusion was made that in the meantime developed New Trend that comprises high educational level segment of population of Argentina that in the future can become the germ of Cultural Change encompassing the whole society.

Trends in vasectomy and sexually transmitted diseases in Chile: findings from robust national databases.

A controversy about the increase or decline of vasectomy is emerging; however, the evidence is still scarce in Latin America. This ecological study analyzed the vasectomy and sexual transmitted diseases (STD) trends over a period of 10 years in Chile and determined if there is any relationship between them. We conducted a mixed ecological study using secondary and representative data on the number of vasectomies and STD cases from 2008 to 2017. Vasectomy rates were calculated for age-specific groups of men aged 20-59 years, and specific STD (HIV, chlamydia, gonorrhea, trichomoniasis, and syphilis) for the same period. Multivariate negative binomial regression models were fitted to evaluate rate trends and relationships. The mean vasectomy age was 40.3 years, with no significant differences between the years of the study (p = 0.058). The overall vasectomy rate significantly increased from 2008 to 2017 (p < 0.001), with differences between age groups (p < 0.001). The most significant increase was observed in men aged 30-49 (p < 0.001). The STD rates significantly increased (p < 0.05) during the study period. A significant positive correlation was found between vasectomy and gonorrhea incidence rates (p = 0.008) and an inverse correlation was found with hepatitis B incidence rates (p = 0.002). Vasectomy trends and STD rates significantly increased from 2018 to 2017 in Chile. especially among men aged 30-49 years. The relationship between vasectomy and STD increments suggests a new risk factor for reproductive and sexual health policies to aid controlling the HIV and STD epidemic.

Effect of castration and vasectomy on some oxidative stress parameters and blood hormone levels in rats / Efeito da castração e da vasectomia em alguns parâmetros de estresse oxidativo e níveis de hormônios no sangue

Vasectomy and castration are the most preferred surgical methods to control reproduction in males. While sexual functions are terminated reversibly in vasectomy, they are removed irreversibly in castration. After these processes, changes are observed in hormones and oxidative stress parameters. In this study, we investigated the effects of vasectomy and castration operations on blood follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, nitric oxide (NO) and malondialdehyde (MDA) levels in rats. As a result of the analysis, it was determined that FSH, LH, NO, and MDA levels increased (p<0.05) and testosterone levels decreased (p<0.05) in the castration group compared to the sham and vasectomy groups. Considering the data obtained from the present study, when the two operations (vasectomy and castration) are compared in rats, which are preferred for the control of reproduction, it is thought that vasectomy is a healthier method because it is reversible, does not affect hormone levels, and does not increase oxidative stress.

A vasectomia e a castração são os métodos cirúrgicos preferidos para controlar a reprodução no sexo masculino. Enquanto as funções sexuais terminam reversivelmente na vasectomia, elas são removidas irreversivelmente na castração. Após esses processos, são observadas alterações nos hormônios e nos parâmetros de estresse oxidativo. Neste estudo, foram investigados os efeitos das operações de vasectomia e castração nos níveis sanguíneos de hormônio folículo estimulante (FSH), hormônio luteinizante (LH), testosterona, óxido nítrico (NO) e malondialdeído (MDA) em ratos. Como resultado da análise, foi determinado que os níveis de FSH, LH, NO e MDA aumentaram (P<0,05) e os níveis de testosterona diminuíram (P<0,05) no grupo de castração em comparação com os grupos sham e vasectomia. Considerando os dados obtidos no presente estudo, quando comparadas as duas operações (vasectomia e castração) em ratos, preferidas para o controle da reprodução, acredita-se que a vasectomia é um método mais saudável por ser reversível, não afetar os níveis hormonais e não aumentar o estresse oxidativo.

Risk of post-vasectomy infections in 133,044 vasectomies from four international vasectomy practices.

OBJECTIVES: To estimate the risk of post-vasectomy infections in various settings and across various surgical techniques and sanitization practices. PATIENTS AND METHODS: Retrospective review of the records of 133,044 vasectomized patients from four large practices/network of practices using the no-scalpel vasectomy (NSV) technique in Canada (2011-2021), Colombia (2015-2020), New Zealand (2018-2021), and the United Kingdom (2006-2019). We defined infection as any mention in medical records of any antibiotics prescribed for a genital or urinary condition following vasectomy. RESULTS: Post-vasectomy infection risks were 0.8% (219 infections/26,809 procedures), 2.1% (390/18,490), 1.0% (100/10,506), and 1.3% (1,007/77,239) in Canada, Colombia, New Zealand, and the UK, respectively. Audit period comparison suggests a limited effect on the risk of infection of excising a short vas segment, applying topical antibiotic on scrotal opening, wearing a surgical mask in Canada, type of skin disinfectant, and use of non-sterile gloves in New Zealand. Risk of infection was lower in Colombia when mucosal cautery and fascial interposition [FI] were used for vas occlusion compared to ligation, excision, and FI (0.9% vs. 2.1%, p<0.00001). Low level of infection certainty in 56% to 60% of patients who received antibiotics indicates that the true risk might be overestimated. Lack of information in medical records and patients not consulting their vasectomy providers might have led to underestimation of the risk. CONCLUSION: Risk of infection after vasectomy is low, about 1%, among international high-volume vasectomy practices performing NSV and various occlusion techniques. Apart from vasectomy occlusion technique, no other factor modified the risk of post-vasectomy infection.

Factores asociados al rechazo del método anticonceptivo vasectomía en población masculina de Chile / Factors associated with the rejection of the vasectomy contraceptive method in the male population of Chile

Objetivo: Identificar los factores relevantes asociados al rechazo de la vasectomía, en la población masculina de 30 a 60 años, de Chile. Métodos: La muestra fue encuestada a través de Google Forms, con un cuestionario que medía las creencias sobre la vasectomía, evaluada a través de una escala tipo Likert. Las pruebas estadísticas utilizadas fueron chi-cuadrado y la prueba exacta de Fisher. Resultados: Los factores que más relevancia obtuvieron fueron la pertenencia a un grupo religioso y la región de residencia. El 100 % de los participantes que no se identificaban con ningún grupo religioso presentaron una menor percepción negativa de la vasectomía (p = 0,0435). Conclusión: La vasectomía está prejuiciada por falta de conocimientos y accesibilidad hacia ella. Por tanto, urge una mayor difusión de sus beneficios en el sistema de salud público y privado, así también, implementar programas de accesibilidad para hombres que no pretendan tener hijos a futuro(AU)

Objective: Identify relevant factors associated with vasectomy rejection in the male population of Chile, between 30 and 60 years. Methodology: The sample was surveyed through Google Forms, with a questionnaire that measured beliefs towards vasectomy, through a Likert-type scale. The statistical tests used were chi-square and Fisher's exact test. Results: The most relevant factors were membership of a religious group and region of residence. Participants who did not identify with any religious group had a lower negative perception of vasectom (p = 0,0435). Conclusion: Vasectomy is prejudiced by lack of knowledge and accessibility to it. Therefore, there is an urgent need for greater dissemination of its benefits in the public and private health system, also, implement accessibility programs for men who do not intend to have children in the future(AU)

Proceso de toma de decisión de la vasectomía desde la teoría fundamentada / Vasectomy decision-making process from grounded theory / Processo de tomada de decisão sobre vasectomia a partir da teoria fundamentada

Objetivo: Describir el proceso en la toma de decisión para la aceptación o rechazo de la vasectomía desde la perspectiva de los hombres mexicanos. Materiales y método: Estudio cualitativo, exploratorio, con metodología en teoría fundamentada, la muestra fue de 17 hombres; la información se recolectó mediante entrevista semiestructurada, con un análisis artesanal. Resultados: La codificación inicial generó 130 códigos, se encontraron 58 códigos focales que dieron origen a 8 códigos axiales. La codificación teórica genero 3 códigos teóricos: alcance de la información; dualidad en la toma de decisión para la vasectomía; factores para la toma de decisión para la vasectomía. La categoría central denominada pro-ceso para la toma de decisión para la aceptación o rechazo de la vasectomía. Discusión: Esta indagación da pauta a interrogantes que se enfoquen más al proceso en la toma de decisión de los hombres, para un mejor entendimiento de este proceso y eventualmente direccionar de mejor manera los programas de promoción de la vasectomía, las intervenciones de salud y políticas públicas acordes a la realidad que viven los hombres. Conclusión: Los hombres viven un proceso "complejo, lleno de altibajos" para poder tomar la decisión de realizarse la vasectomía o bien rechazarla.

Objective: To describe the decision-making process for the acceptance or rejection of vasec-tomy from the perspective of Mexican men. Method: Qualitative study, exploratory, method-ology with a grounded theory, the sample was 17 men; the information was collected through a semi-structured interview, artisanal analysis. Results: The initial coding generated 130 codes, 58 focal codes were found, which gave rise to 8 axial codes. The theoretical coding generated 3 theoretical codes: scope of information; duality in decision making for vasecto-my; factors for decision making for vasectomy. The central category called the decision-mak-ing process for the acceptance or rejection of vasectomy. Discussion: This investigation gives rise to questions that focus more on the decision-making process of men, for a better under-standing of this process and eventually better direct vasectomy promotion programs, health interventions and public policies according to the reality that men live. Conclusion: Men go through a "complex, full of ups and downs" process to be able to make the decision to have a vasectomy or reject it

Objetivo: Descrever o processo de tomada de decisão para a aceitação ou rejeição da vasec-tomia na perspectiva de homens mexicanos. Método: Estudo qualitativo, exploratório, com metodologia de teoria fundamentada, a amostra foi de 17 homens; as informações foram co-letadas por meio de entrevista semiestruturada, análise artesanal. Resultados: A codificação inicial gerou 130 códigos, foram encontrados 58 códigos focais, que deram origem a 8 códi-gos axiais. A codificação teórica gerou 3 códigos teóricos: escopo da informação; dualidade na tomada de decisão para vasectomia; factores para a tomada de decisão de vasectomia. A categoria central denominou o processo decisório para a aceitação ou rejeição da vasectomia. Discussão: Esta investigação suscita questões que focam mais no processo de tomada de decisão dos homens, para uma melhor compreensão deste processo e, eventualmente, melhor direcionar os programas de promoção da vasectomia, intervenções e políticas públicas de acordo com a realidade que os homens vivem. Conclusão: Os homens passam por um pro-cesso "complexo, cheio de altos e baixos" para poder tomar a decisão de fazer a vasectomia ou rejeitá-la

Vasectomy of golden-headed lion tamarins (Leontopithecus chrysomelas) using local anesthesia after sedation with dexmedetomidine-ketamine-meperidine.

The study evaluated the combination of ketamine, dexmedetomidine, and meperidine for vasectomy in golden-headed lion tamarins. Lidocaine infiltration was required for intraoperative analgesia and atipamezole was used at the end of the procedure. The protocol promoted satisfactory sedation and analgesia with a short recovery time in tamarins.

Assessment of general activity and anxiety-like behavior in mice following tramadol and meloxicam administration for managing immediate post-operative pain

After analgesic administration, we evaluated general activity in the Open-Field and anxiety-like behavior in the Elevated Plus Maze of vasectomized mice. We divided C57BL/6J male mice into eight groups: saline, three non-operated control groups treated with 10 mg/kg meloxicam, 20 mg/kg tramadol, or both intraperitoneally, and four vasectomized mice groups treated with the same analgesic protocol as the control groups. One group of vasectomized mice received both treatments and an additional 10 mg/kg lidocaine at the incision site. We conducted the vasectomy via scrotal approach under isoflurane inhalation anesthesia and performed behavioral tests after full anesthesia recovery. Mice treated with meloxicam demonstrated low ambulation, spontaneous activity, and rearing frequency. Mice treated with tramadol showed spontaneous behavior compared with the saline control. Due to behavior changes demonstrated by meloxicam controls, we were unable to identify whether meloxicam provided adequate analgesia. Vasectomized mice treated with tramadol showed general activity behavior similar to their control but displayed significantly less rearing, suggesting that they were under potential signs of pain or discomfort. In conclusion, the Open Field test and the Elevated Plus Maze can usefully pre-evaluate analgesic protocols to identify possible interference caused by adverse drug effects. For future directions, an appropriate regimen of meloxicam and tramadol for enhancing mice welfare post vasectomy should be better investigated.

Vasectomy re-reversal: effectiveness and parameters associated with its success

ABSTRACT Introduction: When the vasectomy reversal (VR) fails, and the patient desires natural conception with his sperm, vasectomy re-reversal (VRR) is the only alternative. Purpose: To determine the VRR effectiveness and whether specific parameters can be associated with its success. Materials and Methods: We retrospectively evaluated 18 consecutive vasectomized patients, who had failed their VR through bilateral vasovasostomy, and posteriorly were submitted to VRR. The parameters of the study were: age of the patients, elapsed time between vasectomy and VRR (V-VRRt), elapsed time between VR and VRR (VR-VRRt), presence of spermatozoa in the proximal vas deferens fluid (SptzVDF) in the VRR and results of semen analysis after VRR (SA-VRR). Results: The mean of the age of the patients was 44.11±6.55 years (32.0-57.0), the mean of V-VRRt was 11.76±6.46 years (1.5-25.0) and the mean of VR-VRRt was 2.13±2.27 years (0.5-10.0). SptzVDF in the VRR were found bilaterally in 8 patients, unilaterally in 4 and absent in 6. SA-VRR demonstrated normozoospermia in 9 patients, oligozoospermia in 3 and azoospermia in 6, with patency rate of 66.67%. SA-VRR showed statistically significant dependence only with SptzVDF in the VRR (p <0.01). Conclusions: VRR was effective in restoring the obstruction in more than half of the patients. Furthermore, the presence of spermatozoa in the vas deferens fluid was the parameter associated with the VRR success.

Systematic STR analysis of old post-vasectomy seminal fluid stains to examine evidence stored for 16 years.

To understand stored evidence and the insertion in genetic databases is important in forensic investigations. Blood, pre- and post-vasectomy semen from 90 fertile male individuals, aged 24 to 45, were donated for research after informed consent. The semen samples were stored in the form of 30 µL stains on cotton fabric, for 16 years at room temperature in the laboratory. As well as the seminal fluid post vasectomy stains, which were performed after microscopy analyzes and certainty of the absence of spermatozoon. The pre vasectomy stains contained mainly haploid spermatozoon and the post vasectomy stains diploid epithelial cells and leukocytes. DNA extraction was performed with magnetic resin, followed by quantification and analysis of degradation of DNA. In this study we analyze these genetic profiles of DNA from stains on cotton fabric, using two Short Tandem Repeat multiplex systems, the PowerPlex Fusion 6C and Y23. Electrophoresis was performed on a 3500xL and analyzed using the Gene Mapper ID-X software. The genetic profiles of the 90 individuals were fully amplified in pre-vasectomy and partially in post-vasectomy stain samples, using the both multiplex systems. The results provide information about 0.25 cm2 semen stains on cotton fabric from 90 individuals, correlating concentration, degradation, and allele analysis. It also provides an understanding of the cells present in semen stains and the implications of individual factors. In the stains of post-vasectomy samples the small quantity of DNA was one of the limiting factors, in addition to degradation. Considering that all evaluations were carried out in a laboratory that has a quality control certificate and audited for being part of the national genetic profile database, the results were very consistent. Many aspects of the semen samples stored in the form of stains on cotton fabric have been clarified. The performance and sensitivity of the amplification systems used in the genotyping of azoospermic individuals were assessed. Conclusions: Genetic profiles were satisfactorily amplified in pre-vasectomy stain samples, and partially amplified in post-vasectomy stain samples, stored for almost two decades at room temperature in a tropical country. The small amount of DNA was one of the limitations in post-vasectomy stain samples, in addition to degradation and fragmentation. There are no publications in the literature on PowerPlex Fusion 6C and Y23 analyses using blood, sperm, and seminal fluids of the same individual, much less in the form of stains. This study can serve as a benchmark for the tracking analyses of stored samples. In addition, it anticipates a few social issues related to the analysis of post-vasectomy samples in forensic cases, most notably sex crimes.

Vasectomy re-reversal: effectiveness and parameters associated with its success.

INTRODUCTION: When the vasectomy reversal (VR) fails, and the patient desires natural conception with his sperm, vasectomy re-reversal (VRR) is the only alternative. PURPOSE: To determine the VRR effectiveness and whether specific parameters can be associated with its success. MATERIALS AND METHODS: We retrospectively evaluated 18 consecutive vasectomized patients, who had failed their VR through bilateral vasovasostomy, and posteriorly were submitted to VRR. The parameters of the study were: age of the patients, elapsed time between vasectomy and VRR (V-VRRt), elapsed time between VR and VRR (VR-VRRt), presence of spermatozoa in the proximal vas deferens fluid (SptzVDF) in the VRR and results of semen analysis after VRR (SA-VRR). RESULTS: The mean of the age of the patients was 44.11±6.55 years (32.0-57.0), the mean of V-VRRt was 11.76±6.46 years (1.5-25.0) and the mean of VR-VRRt was 2.13±2.27 years (0.5-10.0). SptzVDF in the VRR were found bilaterally in 8 patients, unilaterally in 4 and absent in 6. SA-VRR demonstrated normozoospermia in 9 patients, oligozoospermia in 3 and azoospermia in 6, with patency rate of 66.67%. SA-VRR showed statistically significant dependence only with SptzVDF in the VRR (p <0.01). CONCLUSIONS: VRR was effective in restoring the obstruction in more than half of the patients. Furthermore, the presence of spermatozoa in the vas deferens fluid was the parameter associated with the VRR success.

Comparison of midazolam and butorphanol combined with ketamine or dexmedetomidine for chemical restraint in howler monkeys (Alouatta guariba clamitans) for vasectomy.

BACKGROUND: This study evaluated and compared cardiorespiratory and blood gas parameters, as well as sedation, analgesia and recovery of two protocols: ketamine (10 mg/kg) or dexmedetomidine (10 µg/kg), with midazolam (0.5 mg/kg) and butorphanol (0.3 mg/kg), IM (KBM and DBM, respectively) in brown howler monkeys (Alouatta guariba clamitans). MATERIAL AND METHODS: Twelve brown howler monkeys were selected in two groups and evaluated for cardiorespiratory parameters and sedation, from 5-30 minutes after latency. Blood gas and arterial lactate were taken at 5 and 30 minutes. In the end, time and quality of recovery were evaluated. RESULTS: The HR in DBM group was significantly lower at all times. The sedation score was higher in DBM. Recovery in DBM was faster. All animals had moderate hypoxaemia. CONCLUSION: Both protocols produce satisfactory anaesthesia and analgesia, but DBM provides deeper sedation with faster recovery. Oxygen supplementation is recommended in both due to hypoxaemia.

Untargeted metabolomic profiling of accessory sex gland fluid from Morada Nova rams.

The present study was conducted to characterize the metabolome of accessory gland fluid (AGF) of locally adapted Morada Nova rams, raised in the Brazilian Northeast. AGF was collected by an artificial vagina from five vasectomized rams. Metabolites were identified by gas chromatography-mass spectrometry (GC/MS) and high-performance liquid chromatography-mass spectrometry (LC/MS), with the support of Human Metabolome Database, PubChem, LIPID Metabolites, Pathways Strategy databases, and MetaboAnalyst platforms. There were 182 and 190 metabolites detected by GC/MS and LC/MS, respectively, with an overlap of one molecule. Lipids and lipid-like molecules were the most abundant class of metabolites in the ram AGF (127 compounds), followed by amino acids, peptides, and analogs(103 metabolites). Considering all GC/MS and LC/MS, fructose, glycerol, citric acid, d-mannitol, d-glucose, and l-(+)-lactic acid were the most abundant single metabolites present in the ram AGF. Meaningful pathways associated with AGF metabolites included glycine, serine and threonine metabolism; pantothenate and CoA biosynthesis; galactose metabolism; glutamate metabolism and phenylalanine metabolism, and so forth. In conclusion, the combined use of LC/MS and GC/MS was essential for getting a holistic view of the compounds embedded in the ram AGF. Chemical analysis of the accessory sex gland secretion is relevant for understanding sperm function and fertilization.

Is time since vasectomy more important as prognostic factor for pregnancy and live birth than female and laboratory variables when treating vasectomised man using ICSI?

Fatherhood after vasectomy can be done by vasectomy reversal or intracytoplasmic sperm injection (ICSI). Time since vasectomy is the best predictive factor for patency and live birth after a vasectomy reversal but has uncertain importance after ICSI with sperm retrieval. The present study examines the influence of male, female and laboratory variables on pregnancy and live birth. The study is based on 450 ICSI cycles from 332 patients performed on three infertility centres between 1994 and 2012. Interval time since vasectomy was divided in four groups GI-less than 3 years (n = 02); GII-3 to 8 years (n = 74); GIII-9 to 14 years (n = 161) and GIV-15 or more years (n = 213). The variables were tested for pregnancy rate and live birth for first and repeated cycles. Pregnancy and live birth rate were not statistically different among the study interval time groups for first or repeated cycles. Female and laboratory variables were statistically different for couples with pregnancy and live birth for the first cycles. The study suggests that variables coming from female and laboratory were more important than time since vasectomy when treating man with vasectomy using ICSI with sperm retrieval.

Risk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive study.

OBJECTIVE: To evaluate the occlusive failure risk of ligation and excision with fascial interposition vasectomy technique. There are doubts about the effectiveness of this technique largely used in Asia and Latin America. STUDY DESIGN: We conducted a prospective longitudinal observational descriptive study among men who underwent a vasectomy performed under local anesthesia in a clinic specializing in sexual and reproductive health services in Bogotá, Colombia. Three urologists used the Percutaneous No-Scalpel Vasectomy technique to isolate the vas deferens. They then ligated the vas, excised a 1 cm segment between ligations, and ligated the fascia on the prostatic end to cover the testicular end. We requested all patients to submit a semen sample three months after the vasectomy. We defined probable and confirmed vasectomy failure as 1-4.9 million sperm/ml and 5 million sperm/ml or more or any number of motile sperm observed on the last semen sample available, respectively. RESULTS: Among 1149 participants, 581 (51%) had at least one post-vasectomy semen analysis. The overall failure risk was 5.2% (30/581; 95% confidence interval [CI] 3.6%-7.3%) with probable and confirmed failure risk of 1.9% (11/581; 95% CI 1.1%-3.4%) and 3.3% (19/581; 95% CI 2.1%-5.1%), respectively. Older men and one urologist had statistically significant higher risk of overall failure. CONCLUSION: Our study confirmed that the ligation and excision with fascial interposition vasectomy technique is associated with an unacceptable risk of failure. IMPLICATIONS: Surgeons who use the ligation and excision with fascial interposition vasectomy technique and countries with large vasectomy programs in Asia and Latin America that still recommend this technique should consider adopting alternatives to reduce the failure risk to below 1% as recommended by the American Urological Association.

Do assisted reproduction outcomes differ according to aetiology of obstructive azoospermia?

Azoospermia is defined as absence of spermatozoa and may be secondary to blocked seminal ducts, known as obstructive azoospermia. Semen quality may be impaired due to factors such as sperm cell DNA fragmentation and presence of antisperm antibodies. The objective of this article was to investigate potential differences in outcomes of in vitro fertilisation and intracytoplasmic sperm injection between groups with different obstruction aetiology, as well as between the use of different techniques and sperm cells of different origins. Retrospective, multi-centre analysis of 621 first cycles was carried out between 2008 and 2015: Group I, congenital obstruction, 45 patients and Group 2, vasectomy, 576 patients. Sperm cell retrieval was achieved in all cases. Results were similar for Group I and II fertilisation rates, 70% versus 66.85% (p = .786); pregnancy rates, 42.5% versus 41.46% (p = .896); and live birth rates, 29.73% versus 17.69% (p = .071). According to sperm cell origin (579 epididymal vs. 42 testicular), pregnancy rates, 41.47% versus 43.9% (p = .760); and live birth rates, 18.3% versus 27.78% (p = .163) had no difference. Fertilisation, pregnancy and live birth rates did not differ according to obstruction aetiology. Outcomes did not differ between groups according to sperm cell origin.

Successful twin pregnancy with intracytoplasmic sperm injection using surgical sperm retrieval after 25 years of vasectomy: a case report.

The couple from this clinical case consisted of a 55 years old male with an obstructive interval of 25 years post vasectomy, and a 38 years old female partner. Both partners had normal results in infertility workup. Five mature oocytes were injected with motile spermatozoa showing morphological alterations, obtained by percutaneous epididymal sperm aspiration. Four oocytes fertilized, and three embryos were transferred with assisted hatching on day three of development, of which one was a high-quality embryo. A clinical pregnancy was confirmed by the detection of two gestational sacs with foetal heartbeats. Pregnancy was ongoing during the submission of this manuscript. The use of ICSI with PESA/TESA should be considered as a feasible alternative when vasectomy reversal fails in vasectomized men wishing to father again. Case reports like this may inspire the counseling of couples that have suffered from a previous vasectomy reversal failure and support the recommendation of ICSI with PESA treatment, which could allow those couples to have their own children, even in the presence of advanced parental age.

Knowledge and Acceptance towards Vasectomy in a Sample of Medicine Students, Meta 2018 / Conocimientos y aceptación sobre vasectomía en una muestra de estudiantes de medicina, Meta 2018

Introduction The low adherence to vasectomy is associated with the cultural environment, with false beliefs, and with lack of knowledge. In Colombia, the practice of vasectomy increased 3% between 1990 and 2015. Medical education seeks to have an impact on the general population; therefore, medicine students should have knowledge and attitudes toward birth control that include a significant participation of the male gender. Objective To describe the level of knowledge, beliefs, and acceptance of vasectomy in a sample of Colombian medicine students. Methods Cross-sectional descriptive study, nonprobabilistic sample by convenience with a total of 112 medicine students from different universities of the country attending at a university event. A total of 20 dichotomous questions were used. Results A total of 72.3% of the students answered correctly most of the answers; the knowledge level was grouped in high (53.35%), medium (41.07%), and low (5.35%). Up to 95.5% of the students recognized vasectomy as a male birth control method. Regarding beliefs, > 99% considered that family planning is not just a responsibility of women, although only 75% of the men would accept undergo a vasectomy. Conclusions Colombian medicine students have a good level of knowledge about vasectomy, they recommend performing the surgery, and recognize the active participation of males in contraception; nevertheless, a higher willingness to perform a vasectomy would be expected from this population. Training on the subject would break barriers about beliefs and promote proper counseling in birth control consultations.

Introducción La poca adherencia a la vasectomía se asocia al entorno cultural, falsas creencias y bajo conocimiento. En Colombia, su prevalencia incrementó 3% entre los años 1990 y 2015. La educación Médica busca tener impacto sobre la población general, por lo cual el estudiante de medicina debe tener conocimientos y actitudes sobre la planificación familiar, que incluya una participación significativa del sexo masculino. Objetivo Describir el nivel de conocimiento, creencias y aceptación de la vasectomía en una muestra de estudiantes de medicina colombianos. Métodos Estudio descriptivo transversal, muestra no probabilista por conveniencia de 112 estudiantes de medicina, de diferentes universidades del país asistentes a un evento universitario. Se emplea instrumento de 20 preguntas dicotómicas. Resultados El 72,3% de los estudiantes acertó correctamente en la mayoría de las respuestas, se agrupó nivel de conocimiento en alto 53,35%, medio 41,07% y bajo 5,35%. Hasta un 95,5% reconoció la vasectomía como método de planificación masculina. En cuanto a creencias, más del 99% manifiesta que la planificación familiar no es responsabilidad solo de la mujer, aunque sólo el 75% de los hombres aceptó realizarse la vasectomía. Conclusiones Los estudiantes de medicina colombianos tienen un buen nivel de conocimientos sobre vasectomía, recomiendan su realización y reconocen la participación activa masculina dentro de la anticoncepción, sin embargo, se esperaría una mayor disposición, por parte de esta población, a la realización de la vasectomía. La capacitación sobre el tema puede romper las barreras de creencias y promover un adecuado asesoramiento en las consultas de planificación familiar.