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Latest Studies on Vasectomy: Implications & Findings

Explore recent clinical research findings on vasectomy success rates, occlusion methods, and contraception reliability. Learn about pregnancy rates, optimal occlusion techniques, and when men can rely on vasectomy for contraception, with insights from studies in different countries.

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Latest Studies on Vasectomy: Implications & Findings

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  1. Clinical Research on NSV Recent Findings and Programmatic Implications

  2. Programmatic Implications of Clinical Research Findings New evidence on: • pregnancy rates following vasectomy • effectiveness of different occlusion methods • when can men rely on their vasectomy for contraception • cautery device reuse EngenderHealth

  3. Location Failure rate Time after vasectomy US 1.9% 3 years China 4.2% 1 years 9.5% 5 years Nepal 4.2% 3 years Pregnancy Rates After Vasectomy Sources: Costello et al, Centers for Disease Control & Prevention, unpublished; Wang, Contraception; 2002 and Nazerali et al. Contraception, 2003 EngenderHealth

  4. What is the Best Vas Occlusion Technique? Recent results based on semen analysis: • Retrospective review • Clips - 7.1% (103/1453) • Cautery - 0.09% (1/1165) • Prospective, non-comparative study • Ligation & excision alone - 11.5% (25/217) Sources: Labrecque et al. J Urol 2002; Barone et al. J Urol in press, 2003 EngenderHealth

  5. Vasectomy Failure and Recanalization Rates Recanalization based on qualitative assessment by 3 masked reviewers Failure defined as > 10 million sperm/mL at 12 weeks or later EngenderHealth

  6. When Can Men Rely on Their Vasectomy for Contraception? • Ideal is semen analysis to confirm azoospermia (or severe oligospermia) • Semen analysis unavailable or inaccessible in many low resource settings • A common recommendation is after 12 weeks or 20 ejaculations EngenderHealth

  7. 20 ejaculations 12 weeks 100 90 80 70 60 50 40 30 20 10 0 When Can Men Rely on Their Vasectomy for Contraception? azoospermia < 3 million / mL 3-20 million/ml. 20 million + / mL EngenderHealth Source: Barone et al, in press, 2003

  8. Severe Oligospermia at 12-14 Weeks and 20 Ejaculation After Vasectomy EngenderHealth

  9. Conclusions… • Vasectomy failures may be more common than generally thought, none the less vasectomy is an excellent method • Ligation & excision without fascial interposition is an inferior occlusion method • Cautery appears to be better than ligation & excision with fascial interposition • 12 weeks is a better endpoint than 20 ejaculations for when men can rely on their vasectomy in setting where semen analysis is not practical EngenderHealth

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