179 Retrospective study of multiple factors affecting surgical outcomes and patency rates in use of single-armed two-suture technique for microsurgical vasoepididymostomy: A single surgeon's experience with 81 patients

Hong, Kai; Zhao, Liping; Xu, Shuchang; Tang, Wen-Ruei; Mao, Jennifer; Liu, D.; Lin, Haiqing; Zhang, H.; Jiang, Huimin; Ma, Li; Qiao, Jianliang

doi:10.1016/s1569-9056(16)60181-1

Cited by 1 publication

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“…The literature search yielded 319 potentially relevant articles, from which 10 relevant studies met the inclusion criteria ( 9 – 18 ), including eight prospective cohort studies ( 9 – 12 , 14 , 16 – 18 ) and two retrospective cohort studies ( 13 , 15 ). The PRISMA flow diagram in Figure 1 shows the literature search process.…”

Section: Resultsmentioning

confidence: 99%

“…A total of six clinical studies contain sperm parameters after MVE ( 9 , 12 , 13 , 16 – 18 ). These studies include 239 patients and the follow-up data containing sperm parameters were 219 patients ( Table 5 ).…”

Section: Resultsmentioning

confidence: 99%

“…A total of four clinical studies with end-to-side or end-to-end anastomosis ( 9 – 12 ) and six clinical studies with longitudinal or triangular intussusception ( 13 – 18 ) were included in the subgroup analysis. In this subgroup analysis, the random-effect models were uniformly presented as a high inter-study heterogeneity ( P = 0.23 vs .…”

Section: Resultsmentioning

confidence: 99%

“…. The overall patency rate of the vas deferens after MVE A total of 10 clinical studies, including 504 patients were reviewed (9)(10)(11)(12)(13)(14)(15)(16)(17)(18). In this analysis, a random-effect model was proposed for the high inter-study heterogeneity (P = 0.006, I 2 = 61%).…”

Section: Literature Search Process and Resultsmentioning

confidence: 99%

“…A total of 10 clinical studies were reviewed for inclusion, in which 173 patients' spouses achieved pregnancy (9)(10)(11)(12)(13)(14)(15)(16)(17)(18). In this analysis, a random-effect model was presented for the high interstudy heterogeneity (P = 0.0002, I 2 = 72%).…”

Section: The Ratio Of Pregnancy By Art After Mvementioning

confidence: 99%

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The pregnancy outcomes in patients with epididymal obstructive azoospermia after microsurgical vasoepididymostomy: a systematic review and meta-analysis

Wang

Song

et al. 2023

Front. Med.

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PurposePregnancy outcomes (overall patency rate, overall pregnancy rate, natural pregnancy rate, and the ratio of patients with pregnancy by assisted reproductive technology) after microsurgical vasoepididymostomy (MVE) in patients with epididymal obstructive azoospermia (EOA) were assessed through meta-analysis.MethodWe searched PubMed, Embase, Web of Science, and the Cochrane Library databases up to 28 September 2022 for published literature related to retrospective or prospective clinical studies of obstructive azoospermia after apparent microsurgical vasoepididymostomy. Our search terms included obstructive azoospermia, epididymis obstruction, epididymal obstruction and vasoepididymostomy, and epididymovasostomy. Two researchers independently performed the literature search and assessed the eligibility of selected studies according to established inclusion criteria. The meta-analysis was performed using RevMan 5.4 software.ResultA total of 504 patients with EOA were included in 10 studies (including 2 prospective clinical studies and 8 retrospective clinical studies). The mean patency rate after MVE was 72% (95% CI 68–76%). The overall pregnancy rate was 34% (95% CI 30–38%). The natural pregnancy rate is 21% (95% CI 17–24%). The ratio of patients with pregnancy by assisted reproductive technology (ART) was 34.9%. For the factors affecting pregnancy outcomes after MVE, the overall pregnancy rates in patients receiving bilateral MVE were significantly higher than those receiving unilateral MVE (75.4 vs. 24.6%). The mean best sperm count and sperm motility in patients with overall pregnancy were significantly higher than those with failing pregnancies. For the subgroup meta-analysis of microsurgical vasoepididymostomy, there were no statistically significant differences in the overall patency rate (68 vs. 70%), the overall pregnancy rate (33 vs. 37%), the natural pregnancy rate (20 vs. 23%), the ratio of ART (30 vs. 28%) in end-to-side or end-to-end anastomosis, and longitudinal or triangular intussusception MVE.ConclusionVasectomy patency rates are higher, but natural pregnancy rates are lower in EOA male infertility patients after MVE. Altering the MVE procedures alone does not significantly improve pregnancy outcomes, but ART after MVE could improve the chance of pregnancy regardless of sperm parameters. We recommended that human sperms from EOA male infertility patients should be cryopreserved during intraoperative MVE for application in the subsequent ICSI treatment procedure.

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