Antisperm Antibody Levels After Vasectomy Reversal Are Not Associated With Pregnancy Rates or Method of Conception

Abstract

ObjectiveTo examine the relationship between ASA, pregnancy rates, and method of conception following vasectomy reversal, given that before and after vasectomy reversal, patients wonder if antisperm antibodies (ASAs) will prevent them from achieving pregnancy and American Urological Association vasectomy guidelines call for additional research to answer this question. MethodsWe performed retrospective chart review and phone interview of patients who underwent vasectomy reversal at our institution from 1/1/2000 – 12/31/2018. We excluded patients who underwent vasectomy reversal for pain, or without postoperative semen analysis with ASA. We categorized patients as having low (<50%) or high (> 50%) ASA levels using the first postoperative semen analysis. Our primary outcome was pregnancy rate, including method of conception. Differences in pregnancy rates were tested using Fisher’s exact test. Results204 patients were chart reviewed. Median age at time of surgery was 40 years and median obstruction interval was 7.3 years. Median partner age was 32 years. 164 (80%) patients underwent bilateral vasovasostomy. 85 patients (42%) had low (<50%) ASA levels and 119 (58%) had high (≥ 50%) ASA levels.67 patients completed phone interviews. Of 27 men with low ASA levels, 19 (70%) achieved a pregnancy with 16 (59%) spontaneous pregnancy. Of 40 men with high ASA levels, 30 (75%) achieved a pregnancy with 16 (40%) spontaneous pregnancy. The Fisher’s exact test p-value was 0.2. ConclusionASA levels are not associated with pregnancy rate or method of conception after vasectomy reversal. These findings can improve patient counseling before and after vasectomy reversal.