We compared vasoepididymostomy to microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection for treatment of epididymal obstruction secondary to vasectomy.
Results in patients who underwent vasoepididymostomy for vasectomy reversal at our institution were compared to those reported previously for microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection performed for obstructive azoospermia.
The pregnancy rates, delivery rates, complications, cost per procedure and cost per delivery were compared.
A cost per newborn analysis was performed using pregnancy and delivery rates, and reported cost estimates for the complications of assisted reproductive techniques.
A total of 55 men underwent 58 vasoepididymostomies in an attempt to restore fertility after vasectomy.
Median followup was 19 months (range 0 to 115).
Median obstructive interval was 12 years.
There were no major complications.
The patency rate after 6 months was 85%. Of the couples 20 achieved 24 pregnancies and 16 had 17 live births.
The pregnancy rate at 1 year was 44%. There were 4 miscarriages and there are 3 ongoing pregnancies.
The live delivery rate was 36%. Assuming a 29% delivery rate for microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection, the cost per newborn was $51,024, compared to $31,099 for vasoepididymostomy. (...)
Mots-clés Pascal : Vasectomie, Traitement, Anastomose chirurgicale, Epididyme, Canal déférent, Indication, Etude comparative, Ponction aspiration, Sperme, Injection, Intracellulaire, Fécondation in vitro transfert embryon, Résultat, Homme, Chirurgie, Appareil génital mâle, Economie santé
Mots-clés Pascal anglais : Vasectomy, Treatment, Surgical anastomosis, Epididymis, Vas deferens, Indication, Comparative study, Aspiration punction, Semen, Injection, Intracellular, In vitro fertilization embryo transfer, Result, Human, Surgery, Male genital system, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0408062
Code Inist : 002B25K. Création : 19/12/1997.