Patency and Pregnancy Rates are Related to the Effects of Vasectomy on the Human Testis

Abstract

Objectives: To evaluate the effects of vasectomy on the human testis by serum follicle-stimulating hormone, luteinizing hormone and total testosterone levels, testicular volume and testicular biopsy. Also, to correlate patency and pregnancy rates following vasectomy reversal. Patients and Methods: Fifty-seven patients who underwent vasectomy reversal and testicular biopsy were divided in 2 groups: group I consisted of patients with an interval of obstruction of 3–8 years (n = 34), and group II, patients with 9–15 years interval of obstruction (n = 23). Results: Serum follicle-stimulating hormone, luteinizing hormone and total testosterone levels and testicular volumes were normal in each evaluated patient. A normal testis biopsy was found in 61.2% (41/67) of the patients in group I and in 45.6% (21/46) in group II. Compared to group II, group I had higher patency (p < 0.05) and pregnancy rates (p < 0.05) following vasectomy reversal. Patients with atrophic testis did not have patency or established a pregnancy in their wives. Patients with normal spermatogenesis had a higher patency and pregnancy rate compared to others. Conclusion: Up to 15 years after vasectomy, spermatogenesis evaluated by testicular biopsy may not be compromised. Vasectomy causes time-dependent damage as observed in men who request vasectomy reversal within or more than 9 years after their vasectomy. Patients with normal spermatogenesis had a higher patency and pregnancy rates compared to patients with signs of atrophy. These results should be taken into account when vasectomized men, who request reestablishment of fertility after vasectomy, are being counseled and in the selection of patients for treatment.