Vasectomy reversal performed 15 years or more after vasectomy: correlation of pregnancy outcome with partner age and with pregnancy results of in vitro fertilization with intracytoplasmic sperm injection.

OBJECTIVE: To document a contemporary series of vasectomy reversals performed in men 15 years or more after vasectomy and to correlate the results with spousal age and results of ICSI for obstructive azoospermia.
SETTING: University referral center for male infertility.
DESIGN: Retrospective analysis of a single surgeon's experience compared with reported ICSI results. PARTICIPANT(S): One hundred seventy-three men who had vasectomy reversal 15 years or more after vasectomy. INTERVENTION(S): Reversal of vasectomy by vasovasostomy or epididymovasostomy. MAIN OUTCOME MEASURE(S): Correlation of pregnancy results after vasectomy reversal with spousal age and published ICSI results. RESULT(S): Pregnancy rates for the intervals of 15-19 years, 20-25 years, and >25 years after vasectomy were 49%, 39%, and 25%, respectively. For spousal age <30 years, 30--35 years, 36-40 years, and >40 years, pregnancy rates were 64%, 49%, 32%, and 28%, respectively. The overall pregnancy rate was 43%, which is similar to the pregnancy rate of 40% for ICSI in obstructive azoospermia. Sixty-two percent of the men required a unilateral or bilateral epididymovasostomy. CONCLUSION(S): Spousal age is an important predictive factor after vasectomy reversal among men who have reversal 15 years or more after vasectomy. Pregnancy rates after vasectomy reversal compare favorably with those obtained with ICSI.