NEW YORK (Reuters Health) - Findings from a new study indicate that vasectomy reversal offers a reasonable chance for pregnancy even when the female partner is 35 years of age or older.

In this setting, the chance for success is comparable to that of one cycle of in vitro fertilization with intracytoplasmic sperm injection, lead author Dr. Peter N. Kolettis, from the University of Alabama at Birmingham, and colleagues note.

The findings, which are published in the June issue of The Journal of Urology, are based on a study of 46 couples that were trying to establish a pregnancy. In each couple, the male partner had undergone vasectomy reversal and the female partner was at least 35 years of age. The median time between vasectomy and reversal was 10 years.

The reversal procedure involved bilateral vasovasostomy in 43 men, unilateral vasovasostomy in 2 men, and vasovasostomy/vasoepididymostomy in 1 man.

The patency rate in the 27 men who had follow-up semen analyses was 81%, the researchers note. Transient patency was observed in 2 men.

Of the 40 couples with adequate follow-up, pregnancy occurred in 14 (35%). Thirteen of these pregnancies were still viable or had been delivered by the end of the study.

The pregnancy and ongoing/live delivery rates for women in their late 30s were 46% for each. For women in their 40s, these rates fell to 14% and 7%, respectively.

The results suggest that "couples should not be eliminated from consideration for reversal simply because the female partner is 35 years old or older," the authors note. However, "in our series there was only 1 live delivery for a women older than 40 years and, therefore, careful preoperative counseling is required for these couples," they add.

J Urol. 2003 Jun;169(6):2250-2

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