Fertility status of men following vaso-vasostomy.

ABSTRACT

PIP In 1977, 114 vas reanastomoses were performed at the S.V.B.P. Hospital in Meerut, India. Follow-up of 74 of the cases indicated that 81.08% of the procedures were technically successful in that an adequate sperm count was reestablished; however, clinical success, as measured by the wife's subsequent pregnancy, was achieved in only 20.27% of the cases. Wives who did not conceive were gynecologically examined and no abnormalities were observed. In order to identify factors which contributed toward fertility restoration failure the investigators assessed the relationship between clinical and technical success and 1) the age of the patient; 2) the length of the interval between the vasectomy and the reversal procedure; and 3) the presence of sperm agglutinating and sperm immobilizing antibodies in the blood serum of the patients. The age of the patient was not related to either clinical or technical success. The length of the interval between vasectomy and reversal did not affect technical success; however, as the interval increased, clinical success declined. Serum samples were obtained from 86 of the 114 patients and from a control group of 24 fertile men and examined for the presence of sperm agglutinating and sperm immobilizing antibodies. The antibodies were absent in the sera of all but 1 of the controls; however, both types of antibodies were present in the sera of 32 of the patients and sperm agglutinating antibodies only were present in the sera of another 26 patients. The presence of the antibodies was not related to technical success but the presence of the antibodies did appear to have an adverse effect on clinical success. This relationship also appeared to be influenced by the length of the interval between vasectomy and vas reanastomosis. Major findings were presented in tabular form.^ieng