The Need for Sperm Cryopreservation at the Time of Vasovasostomy or Vasoepididymostomy

Lee, Jae Seok; Seo, Ju Tae

Abstract

PURPOSE: Retrieved sperm or testicular tissues are sometimes cryopreserved at the time of a vasovasostomy or vasoepididymostomy. It is possible to use cryopreserved sperm with intracytoplasmic sperm injection(ICSI) in the case of failure of pregnancy or surgical correction. The need for sperm cryopreservation at the time of a vasovasostomy or vasoepididymostomy was evaluated.
MATERIALS AND METHODS
A total of 61 patients underwent a vasovasostomy and 42 underwent a vasoepididymostomy, performed by one urologist(J.T.S), between May 1994 and April 1999. Follow up data were available for 42 and 32 cases of vasovasostomy and vasoepididymostomy, respectively. Sperm cryopreservation was carried out at the time of the vasovasostomy in 6 cases(6/42) and the vasoepididymostomy in 18(18/32).
RESULTS
The overall patency rates were 92.9(39/42) and 37.5%(12/32) for the vasovasostomy and vasoepididymostomy, respectively. The pregnancy rates in the case of successful surgical correction were 56.4%(22/39) and 41.6%(5/12) for the vasovasostomy vasoepididymostomy, respectively. Only in 8 cases(8/18) were the cryopreservated sperm used after a failed vasoepididymostomy.
CONCLUSIONS
A vasovasostomy exhibited a higher patency and pregnancy rates than a vasoepididymostomy. Routine sperm cryopreservation in men undergoing vasovasostomy is not recommended. Sperm cryopreservation during an operation is recommended for surgical and pregnancy failures, in men undergoing vasoepididymostomy. Intraoperative sperm cryopreservation in men undergoing vasoepididymostomy will maximize the postoperative fertility options.