Sperm Kinetics After VV or VE and Reversal Failure
After a bilateral vasovasostomy, most patients can expect to see sperm on the first semen analyses at 30 days, with counts and motility continuing to improve over several consecutive months. After a vasoepididymostomy, the return of sperm to the ejaculate can be quite variable and unpredictable, with sperm seen anytime from the first semen analysis at 4 weeks up to 6–12 months or more. Failure of a reversal is the inability to see any sperm in the ejaculate by 6 months following a bilateral vasovasostomy and 18 months after a bilateral vasoepididymostomy. There are many possible surgeon- and patient-mediated causes of a failed reversal.
KeywordsPost-reversal sperm kinetics Management of suboptimal or decreasing sperm parameters Failure of VV or VE Causes for reversal failure Prevention of anastomotic scarring
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