MP07-17 FACTORS IMPACTING COUPLES’ DECISION MAKING BETWEEN VASECTOMY REVERSAL VERSUS SPERM RETRIEVAL/IVF/ICSI

Abstract

You have accessJournal of UrologyInfertility: Therapy II1 Apr 2018MP07-17 FACTORS IMPACTING COUPLES’ DECISION MAKING BETWEEN VASECTOMY REVERSAL VERSUS SPERM RETRIEVAL/IVF/ICSI Parviz Kavoussi, Keikhosrow Kavoussi, Kate Odenwald, and Shahryar Kavoussi Parviz KavoussiParviz Kavoussi More articles by this author , Keikhosrow KavoussiKeikhosrow Kavoussi More articles by this author , Kate OdenwaldKate Odenwald More articles by this author , and Shahryar KavoussiShahryar Kavoussi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.3080AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES 500,000 men in the US undergo vasectomy annually. About 6% will change their mind. 2 options to conceive are vasectomy reversal (VR) or sperm retrieval (SR) with in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Often the male partner is only evaluated by a urologist and counseled and treated with a VR without an evaluation or counseling of the female, or the female is evaluated by a reproductive endocrinologist (RE) on the option of IVF/ICSI, and the male partner is referred to a urologist to perform SR for use with IVF/ICSI. Our objective was to identify factors which impact a couples decision making between VR versus SR/IVF/ICSI when counseled both by a reproductive urologist (RU) and a RE. METHODS Retrospective chart review was performed. Between 1/11 to 2/17, all male patients seen by a RU for VR consult as well as all female patients who were seen by a RE for IVF/ICSI with SR consult, were offered evaluation of their respective partner by the other respective specialist. IRB exemption was obtained. Statistical analyses were performed via Students t-test with p value of <0.05 considered significant. RESULTS Of all patients presenting, 175 elected to have their partners evaluated. Mean age of males was 40.5 (SD 6.5, range 26-62) and mean age of females was 33 (SD 4.8, range 19-46). Mean obstructed interval was 9.7 years (SD 6.1, range 1-29). 137/175 (78.3%) of couples opted for VR and 38/175 (21.7%) elected SR/IVF/ICSI. Diminished ovarian reserve (DOR) defined as day 3 follicle stimulating hormone (FSH) > 10 mIU/mL, until 1/13, at which time anti-mullerian hormone (AMH) < 1 ng/mL was used as the criterion for DOR. 25% of females were categorized as having DOR. 23% of couples selecting VR had female partners with DOR, and 31.6% of couples who selected SR/IVF/ICSI had female partners with DOR, 2 of whom opted for donor oocyte IVF/ICSI. There was no statistically significant difference in male or female partner ages between those that selected VR vs SR/IVF/ICSI. There was a significantly longer mean obstructed interval since vasectomy in couples who selected SR/IVF/ICSI versus VR. There was not a significant difference in choosing VR versus SR/IVF/ICSI when the female partner was found to have DOR (p-value 0.3041). CONCLUSIONS Of couples counseled on VR versus SR/IVF/ICSI by a RU and a RE, respectively, the majority selected VR. Male age, female age, and ovarian reserve status did not seem to play a significant role in this decision making; however, a longer obstructed interval since vasectomy was a factor that drove the decision making of couples towards SR/IVF/ICSI. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e94 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Parviz Kavoussi More articles by this author Keikhosrow Kavoussi More articles by this author Kate Odenwald More articles by this author Shahryar Kavoussi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...