Advertisement

Sperm Kinetics After VV or VE and Reversal Failure

  • Sheldon H. F. Marks
Chapter

Abstract

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.

Keywords

Post-reversal sperm kinetics Management of suboptimal or decreasing sperm parameters Failure of VV or VE Causes for reversal failure Prevention of anastomotic scarring 

References

  1. 1.
    Perkins A, Marks MB, Burrows PJ, Marks SF. Sperm kinetics following vasectomy reversal. American Society of Andrology, 37th Annual Meeting, Tucson, Arizona. April 21–24, 2012.Google Scholar
  2. 2.
    Yang G, Walsh TJ, Shefi S, Turek PJ. The kinetics of the return of motile sperm to the ejaculate after vasectomy reversal. J Urol. 2007;177(6):2272–6.CrossRefGoogle Scholar
  3. 3.
    Matthews GJ, Schlegel PN, Goldstein M. Patency following microsurgical vasoepididymostomy and vasovasostomy: temporal considerations. J Urol. 1995;154:2070–3.CrossRefGoogle Scholar
  4. 4.
    Perkins A, Marks MB, Burrows PJ, Marks SF. Anti-inflammatory treatment for asthenozoospermia following microsurgical vasectomy reversal. Poster at the American Society of Andrology, 38th Annual Meeting, San Antonio, Texas. April 13–17, 2013.Google Scholar
  5. 5.
    Royle MG, Hendry WF. Why does vasectomy reversal fail? Br J Urol. 1985;57(6):780–3.CrossRefGoogle Scholar
  6. 6.
    Schiff J, Chan P, Li PS, Finkelberg S, Goldstein M. Outcome and late failures compared in 4 techniques of microsurgical vasoepididymostomy in 153 consecutive men. J Urol. 2005;174:651–5.CrossRefGoogle Scholar
  7. 7.
    Carbone DJ Jr, Shah A, Thomas AJ Jr, Agarwal A. Partial obstruction, not antisperm antibodies, causing infertility after vasovasostomy. J Urol. 1998;159:827–30.CrossRefGoogle Scholar
  8. 8.
    Silber SJ. Epididymal extravasation following vasectomy as a cause for failure of vasectomy reversal. Fertil Steril. 1979;31:309–15.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sheldon H. F. Marks
    • 1
  1. 1.University of Arizona College of MedicineInternational Center Vasectomy ReversalTucsonUSA

Personalised recommendations