Effect of Female Partner Age on Pregnancy Rates after Vasectomy Reversal.

Gerrard ER Jr, Sandlow JI, et al:
Fertil Steril; 2007; 87 (June): 1340-1344

Objective: To determine the effect of female age on pregnancy rates after vasectomy reversal. Design: Retrospective review of men undergoing vasectomy reversal performed by 3 urologic surgeons. Female partners were stratified by age. Participants: 294 men who underwent vasectomy reversal were included. Twenty-one of these men had a female partner aged 20 to 24 years, 80 had a partner aged 25 to 29 years, 117 had a partner 30 to 34 years, 62 had a partner 35 to 39 years old, and 14 of the men had a female partner >=40 years of age. Methods: Microscopic vasovasostomy or vasoepididymostomy was performed under general anesthesia. Pregnancy rates were stratified into the 5 female partner age groups and then collapsed into 2 groups consisting of female partners <40 years old and those >=40 years old. The two-group t test was then performed. The minimum follow-up was 12 months unless pregnancy occurred prior to that. Results: The obstructive interval, type of reversal, mean follow-up time, and patency rates (83% to 99%) were not significantly different when stratified by female age. Pregnancy rates were 14% to 67% and were not significantly different between the 5 female age groups. Stratification into 2 groups showed pregnancy rates with a female partner >=40 years of age were 14% versus 56% for partners <40 years old (P <0.04). Conclusions: A female partner >=40 years of age was a significant factor in pregnancy rates following vasectomy reversal. Reviewer’s Comments: This paper reiterates that it is important to counsel couples about the female partner’s age when discussing vasectomy reversals. This is particularly important in view of similar results in this age group with in vitro fertilization-intracytoplasmic sperm injection and sperm aspiration. One limitation of this study was the small group of cases (n=14) with a female partner >=40 years old. (Reviewer–Ajay K. Nangia, MBBS).