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Related Concept Videos

Infertility in Males01:23

Infertility in Males

633
Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural...
633

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Optimizing the Modified No-Scalpel Vasectomy Technique
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Vasectomy reversal semen analysis: new reference ranges predict pregnancy.

Ahmad Majzoub1, Nicholas N Tadros1, A Scott Polackwich2

  • 1Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

Fertility and Sterility
|March 12, 2017
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Summary

Pregnancy after vasectomy reversal (VR) is achievable with lower semen parameters than previously thought. These findings redefine fertility potential post-VR, offering new hope for men seeking to restore fertility.

Keywords:
Vasectomypregnancy ratesemen analysisvasectomy reversal

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Area of Science:

  • Reproductive Medicine
  • Urology
  • Andrology

Background:

  • Vasectomy reversal (VR) is a common procedure for men desiring to regain fertility.
  • Predictors of vasal patency are understood, but semen parameters and pregnancy potential post-VR require further investigation.

Purpose of the Study:

  • To determine the semen analysis values necessary for achieving pregnancy after vasectomy reversal.
  • To establish reference ranges for postoperative semen parameters in men who achieve spontaneous pregnancy post-VR.

Main Methods:

  • Retrospective case-control study of 139 patients undergoing vasectomy reversal.
  • Analysis of preoperative and postoperative semen parameters, intraoperative findings, and pregnancy outcomes.
  • Statistical analysis using Pearson and t tests to develop average semen reference values.

Main Results:

  • Spontaneous pregnancy was achieved by 49.6% of patients.
  • Pregnancy correlated with intraoperative vasal fluid quality and postoperative sperm concentration, motility, and strict morphology.
  • Achieved pregnancy with semen parameters significantly lower than 2010 WHO standards (e.g., 15% with <5 million/mL sperm concentration).

Conclusions:

  • Standard 2010 WHO semen parameter ranges may not accurately predict fertility post-vasectomy reversal.
  • Lower postoperative semen parameters can be sufficient for achieving pregnancy in previously fertile men after VR.