“For decades, conventional wisdom has been that the older the vasectomy, the less likely that ejaculated sperm returns after microsurgical vasectomy reversal. But this may not be true,” says Dr. Paul Turek, senior author of the study. This assumption has led many doctors to encourage couples to choose in vitro fertilization (IVF), a much more expensive alternative, instead of vasectomy reversal to build families.
In a study of 343 vasectomy reversals from The Turek Clinic, the research compared the outcomes from reversing “younger” vasectomies (1-15 years old) to the outcomes from reversing “older” vasectomies (16-38 years old). Contrary to the predictions of ?several published nomograms and algorithms, the ability to get sperm back in the ejaculate after reversal, also termed “patency,” did not diminish with advanced vasectomy age.
“Older vasectomies up to 38 years did not have worse outcomes after reversal. In fact, the patency rate actually plateaued after 21 years and did not decrease after that” noted Dr. Turek, who specializes in microsurgical vasectomy reversals. The chance of achieving moving ejaculated sperm counts after reversal in men with older vasectomies was 65% compared to 88% in men with younger vasectomies, a difference that was not statistically different. The data presented on patency rates after reversal were further supported by excellent semen analysis outcomes: the mean total number of sperm in men with older vasectomies was 55 million per ejaculate after reversal. “These aren’t ‘predicted’ outcomes from nomograms or algorithms -- they are the real deal from actual patients,” explained Dr. Turek.
This research is particularly timely given the recent New England Journal of Medicine publication of a large study showing that birth defect rates are significantly higher with IVF-ICSI than with natural conception. “I’ve long counseled couples to consider vasectomy reversal as an option for family building. This new data on higher birth defects with IVF-ICSI further supports our approach at The Turek Clinic,” states Dr. Turek.
The research is unique to the field because it focuses on outcomes obtained with vasectomies older than 16 years, a group of patients scarcely mentioned in the literature. “This is good news for couples with infertility caused by older vasectomies -- the results of reversal are much better than previously thought.”