Following vasectomy reversal, patients often have concerns about whether antisperm antibodies (ASAs) will affect their ability to conceive. However, existing research on the relationship between ASA levels and pregnancy rates after vasectomy reversal is limited. A recent retrospective study aimed to examine this relationship and provide insights for patient counseling. This study was published in the journal of Urology by Catherine s. And colleagues.

While vasectomy reversal is a common procedure for restoring fertility in men who have undergone vasectomy, questions remain regarding the impact of ASAs on pregnancy outcomes post-reversal. The American Urological Association vasectomy guidelines highlight the need for further research to address these uncertainties.
The study conducted a retrospective chart review and phone interviews with patients who underwent vasectomy reversal between 2000 and 2018. Patients were categorized based on their ASA levels, and pregnancy rates and methods of conception were analyzed as primary outcomes.
Key Findings:
• A total of 204 patients were included in the study, with a median age of 40 years and a median obstruction interval of 7.3 years.
• 85 patients (42%) had low ASA levels (<50%), while 119 (58%) had high ASA levels (≥50%).
• Among the patients with low ASA levels, 70% achieved pregnancy, with 59% resulting from spontaneous conception.
• For patients with high ASA levels, 75% achieved pregnancy, with 40% resulting from spontaneous conception.
• Fisher's exact test p-value for the difference in pregnancy rates based on ASA levels was 0.2, indicating no significant association.
The study found no association between ASA levels and pregnancy rates or method of conception following vasectomy reversal. These findings provide valuable insights for patient counseling, alleviating concerns regarding the potential impact of ASAs on fertility outcomes post-reversal. As such, clinicians can better inform patients about their likelihood of achieving pregnancy after vasectomy reversal, regardless of ASA levels.
Reference:
Nam, C. S., Tooke, B. P., Strasser, O., Hameed, M. A., Chinnusamy, S., Van Til, M., Daignault-Newton, S., & Dupree, J. M. Antisperm antibody levels after vasectomy reversal are not associated with pregnancy rates or method of conception. Urology,2024. https://doi.org/10.1016/j.urology.2024.02.028