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Hum. Reprod. Advance Access published online on June 15, 2005
Human Reproduction, doi:10.1093/humrep/dei138
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.
Received September 3, 2005
Revised February 17, 2005
Accepted May 6, 2005

Article

Effects of vasectomy on spermatogenesis and fertility outcome after testicular sperm extraction combined with ICSI

C.M. McVicar 1*, D.A. O’Neill 1, N. McClure 1, B. Clements 2, S. McCullough 3, and S.E.M. Lewis 1

1 Obstetrics and Gynaecology
2 Royal Victoria Hospital and
3 Anatomy, School of Medicine, Queen’s University Belfast, Institute of Clinical Science, Grosvenor Rd, Belfast BT12 6BJ, UK

* To whom correspondence should be addressed.
C.M. McVicar, E-mail: c.mcvicar{at}qub.ac.uk


  Abstract

BACKGROUND: Each year 40 000 men have a vasectomy in the UK whilst another 2400 request a reversal to begin a second family. Sperm can now be obtained by testicular biopsy and subsequently used in assisted conception with ICSI. The study aims were to compare sperm yields of men post-vasectomy or with obstructive azoospermia (OA) of unknown aetiology with yields of fertile men and to assess any alteration in the clinical pregnancy rates after ICSI. METHODS: Testicular tissue was obtained by Trucut needle from men who had undergone a vasectomy >5 years previously or had OA from other causes and from fertile men during vasectomy. Seminiferous tubules were milked to measure sperm yields. Numbers of Sertoli cells and spermatids and thickness of the seminiferous tubule walls were assessed using quantitative computerized analysis. RESULTS and CONCLUSIONS: Sperm yields/g testis were significantly decreased in men post-vasectomy and in men with OA, relative to fertile men. Significant reductions were also observed in early (40%) and mature (29%) spermatid numbers and an increase of 31% was seen in the seminiferous tubule wall (basal membrane and collagen thickness) of vasectomized men compared with fertile men. Clinical pregnancy rates in couples who had had a vasectomy were also significantly reduced.

Keywords: clinical pregnancy rate/ICSI/spermatids/sperm yield/vasectomy.
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