Comparison of microscopic epididymal sperm aspiration and intracytoplasmic sperm injection/in-vitro fertilization with repeat microscopic reconstruction following vasectomy: is second attempt vas reversal worth the effort?

Human Reproduction
J F DonovanJ I Sandlow

Abstract

Since 1986, we have performed microscopic reconstruction in 18 men following failed microscopic vasectomy reversal. Between 1994 and 1996, nine couples have undergone microscopic epididymal sperm aspiration (MESA)/ intracytoplasmic sperm injection (ICSI) treatment for male infertility due either to congenital absence of the vas deferens (CAVD) or inoperable excurrent duct obstruction. We compared the cost efficiency of repeat vasectomy reversal to that for MESA combined with ICSI/in-vitro fertilization (ICSI/IVF). The cost of male partner procedures (vasectomy reversal, MESA) was based on physician and hospital charges, while the cost of ICSI/IVF included preparation of the female partner (medications and physician charges) and procedures (physician and hospital charges including oocyte retrieval, micromanipulation, and embryo transfer). Our cost examination does not include charges related to follow-up visits, prenatal monitoring, complications of pregnancy (i.e. miscarriage) or delivery in either group. Overall patency and pregnancy rates in the repeat vasectomy reversal group were 78 and 44% respectively. The cost per delivered baby (including multiple metachronos deliveries per couple) was $14892. Fertilization of oocytes h...Continue Reading

Citations

May 12, 2004·Fertility and Sterility·Peter T K Chan, Marc Goldstein
Jan 31, 2004·Urology·Karen Elizabeth BoyleJonathan P Jarow
Nov 20, 2012·Asian Journal of Andrology·Peter T Chan
Jul 13, 2006·Nature Clinical Practice. Urology·Marc Goldstein, Cigdem Tanrikut
Jun 1, 2000·International Journal of Urology : Official Journal of the Japanese Urological Association·J S Paick
Feb 11, 2003·The Journal of Urology·Jae-Seung PaickSoo Woong Kim
Dec 2, 2010·Human Fertility : Journal of the British Fertility Society·Herman Tournaye
Aug 18, 2005·BJU International·Peter T K ChanMarc Goldstein
Mar 16, 2016·Asian Journal of Andrology·Abhishek P Patel, Ryan P Smith
Oct 12, 2005·The Journal of Urology·Maxwell V MengPaul J Turek
Apr 4, 2006·Fertility and Sterility·Karen E BoyleJonathan P Jarow
Apr 19, 2013·The World Journal of Men's Health·Hyo Serk Lee, Ju Tae Seo
Oct 5, 2001·The Journal of Urology·C G SchrepfermanJ I Sandlow
Sep 21, 2010·Current Opinion in Urology·Anand Shridharani, Jay I Sandlow
Apr 22, 2008·The Urologic Clinics of North America·Richard LeeMarc Goldstein

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