Lower testicular volume and increased vascular resistance is predictive of diminished testicular reserve

Abstract

OBJECTIVE: The American Urologic Association (AUA) Vasectomy Guidelines recommend that a post-vasectomy semen analysis (PVSA) be done 8-16 weeks after vasectomy with either azoospermia or <100,000 non-motile sperm/mL serving as the criteria for vasectomy success. 1 The impact of the period of abstinence (POA) on the results of a PVSA is unknown. A short POA prior to PVSA may serve as a marker of higher sexual activity (i.e. more ejaculations) in the post-vasectomy interval and thus lead to an increased chance of an acceptable PVSA. However, while studies have shown alterations in sperm concentration and motility with variable POAs for a routine semen analysis, it is unclear if POA has an impact on the chance of finding <100,000 non-motile sperm/mL on PVSA.DESIGN: Retrospective review of patients who had a vasectomy by a single urologist.MATERIALS AND METHODS: With institutional board approval, the PVSAs of men who had a vasectomy by a single urologist between January 2000 and July 2017 were retrospectively analyzed. Information was collected on the time since vasectomy, days of abstinence prior to collection, sperm count, and motility. Student t-tests were performed to examine the impact of POA on PVSA.RESULTS: In total, 875 men who underwent a vasectomy returned for a PVSA. Of these, 794 men (90.7%) had a PVSA demonstrating azoospermia and 48 (5.5%) had >100,000 sperm/mL or motile sperm. In the azoospermic men, the mean time since vasectomy was 151 days (range 10-1989) compared to 100 days (range 24-189) in those with >100,000 sperm or motile sperm (p ¼ 0.15), and no difference in the POA was observed (4.4 vs 5.3 days respectively, p ¼ 0.27). When examining men whose PVSA was done within the recommended 8-16 weeks after vasectomy, no difference in the POA between men with azoospermia and those with >100,000 sperm/ mL or motile sperm was observed (3.4 vs 3.3 days, p ¼ 0.84). Even when azoospermic men were compared to those with the presence of any sperm on PVSA, there was no difference in the POA (3.4 vs 3.5 days, p ¼ 0.84). Of those men tested < 8 weeks after vasectomy, 23/25 were azoospermic with intervals since vasectomy as short as 10 days and 2/25 demonstrated >100,000 sperm/mL or motile sperm.CONCLUSIONS: The POA does not appear to affect the results of a PVSA. As such, the length of the POA does not need to be considered with regards to when men should provide a PVSA.

Ageing affects plasma steroid concentrations and testicular volume, echotexture and haemodynamics in rams

“…Recently, pulsed‐wave Doppler analysis is used to check the testicular haemodynamics and reproductive efficiency in males. Spectral Doppler indices, resistive index (RI) and pulsatility index (PI) of the testicular artery had close associations with spermatogenesis and steroidogenesis in men (Abittan et al, 2018) and dogs (Trautwein et al, 2020).…”