Long-term management of vasovasostomy patients

Follow-up of 54 patients undergoing modified single-layer bilateral vasovasostomies are presented with attention to semen quality, pregnancy rates, and postoperative findings potentially inhibiting fertility. The technical success rate was 98%, but 3-month semen analyses varied from "poor" (less than 20(6)/ml; greater than 50% normal motility) of 20% to "excellent" (greater than 26(6)/ml; greater than 50% normal motility) of 35% without effect on long-term pregnancy rates, 50% and 54.5%, respectively. Other factors, such as sperm clumping, prostatitis, and immunologic interference, appear to decrease motility. Close follow-up with attention to factors affecting fertility other than simple concentration and motility are rewarding.