Abstract：
To examine the relationship between antisperm antibody (ASA), pregnancy rates, and method of conception following vasectomy reversal, given that before and after vasectomy reversal, patients wonder if ASAs will prevent them from achieving pregnancy and American Urological Association vasectomy guidelines call for additional research to answer this question.
We performed retrospective chart review and phone interview of patients who underwent vasectomy reversal at our institution from 1/1/2000 to 12/31/2018. We excluded patients who underwent vasectomy reversal for pain, or without postoperative semen analysis with ASA. We categorized patients as having low (<50%) or high (≥50%) ASA levels using the first postoperative semen analysis. Our primary outcome was pregnancy rate, including method of conception. Differences in pregnancy rates were tested using Fisher exact test.
Two hundred and four patients were chart reviewed. Median age at time of surgery was 40years and median obstruction interval was 7.3years. Median partner age was 32years. One hundred sixty-four (80%) patients underwent bilateral vasovasostomy. Eighty-five patients (42%) had low (<50%) ASA levels and 119 (58%) had high (≥50%) ASA levels. Sixty-seven patients completed phone interviews. Of 27 men with low ASA levels, 19 (70%) achieved a pregnancy with 16 (59%) spontaneous pregnancy. Of 40 men with high ASA levels, 30 (75%) achieved a pregnancy with 16 (40%) spontaneous pregnancy. The Fisher exact test P-value was .2.
ASA levels are not associated with pregnancy rate or method of conception after vasectomy reversal. These findings can improve patient counseling before and after vasectomy reversal.
We performed retrospective chart review and phone interview of patients who underwent vasectomy reversal at our institution from 1/1/2000 to 12/31/2018. We excluded patients who underwent vasectomy reversal for pain, or without postoperative semen analysis with ASA. We categorized patients as having low (<50%) or high (≥50%) ASA levels using the first postoperative semen analysis. Our primary outcome was pregnancy rate, including method of conception. Differences in pregnancy rates were tested using Fisher exact test.
Two hundred and four patients were chart reviewed. Median age at time of surgery was 40years and median obstruction interval was 7.3years. Median partner age was 32years. One hundred sixty-four (80%) patients underwent bilateral vasovasostomy. Eighty-five patients (42%) had low (<50%) ASA levels and 119 (58%) had high (≥50%) ASA levels. Sixty-seven patients completed phone interviews. Of 27 men with low ASA levels, 19 (70%) achieved a pregnancy with 16 (59%) spontaneous pregnancy. Of 40 men with high ASA levels, 30 (75%) achieved a pregnancy with 16 (40%) spontaneous pregnancy. The Fisher exact test P-value was .2.
ASA levels are not associated with pregnancy rate or method of conception after vasectomy reversal. These findings can improve patient counseling before and after vasectomy reversal.
摘要：
目的：研究抗精子抗体（ASA）与怀孕率,和输精管切除术逆转后的受孕方法，考虑到输精管切除术逆转前后，患者想知道ASA是否会阻止他们实现妊娠,美国泌尿外科协会输精管结扎术指南要求更多的研究来回答这个问题.
方法：我们对2000年1月1日至2018年12月31日在我们机构接受输精管切除术逆转的患者进行了回顾性图表回顾和电话访谈。我们排除了因疼痛而接受输精管切除术逆转的患者，或不使用ASA进行术后精液分析。我们使用第一次术后精液分析将患者分为低（<50％）或高（≥50％）ASA水平。我们的主要结果是怀孕率，包括概念方法。使用Fisher精确检验测试妊娠率的差异。
结果：回顾了两百四例患者。手术时的中位年龄为40岁，中位梗阻间隔为7.3岁。伴侣年龄中位数为32岁。164例（80％）患者接受了双侧血管血管造口术。85名患者（42％）的ASA水平较低（<50％），而119名（58％）的ASA水平较高（≥50％）。67名患者完成了电话采访。在27名ASA水平较低的男性中，19（70％）实现了妊娠，16（59％）自发妊娠。在40名ASA水平高的男性中，30（75％）实现了妊娠，16（40％）自发妊娠。Fisher精确检验P值为.2。
结论：ASA水平与输精管切除术逆转后的妊娠率或受孕方法无关。这些发现可以改善输精管切除术逆转前后的患者咨询。
方法：我们对2000年1月1日至2018年12月31日在我们机构接受输精管切除术逆转的患者进行了回顾性图表回顾和电话访谈。我们排除了因疼痛而接受输精管切除术逆转的患者，或不使用ASA进行术后精液分析。我们使用第一次术后精液分析将患者分为低（<50％）或高（≥50％）ASA水平。我们的主要结果是怀孕率，包括概念方法。使用Fisher精确检验测试妊娠率的差异。
结果：回顾了两百四例患者。手术时的中位年龄为40岁，中位梗阻间隔为7.3岁。伴侣年龄中位数为32岁。164例（80％）患者接受了双侧血管血管造口术。85名患者（42％）的ASA水平较低（<50％），而119名（58％）的ASA水平较高（≥50％）。67名患者完成了电话采访。在27名ASA水平较低的男性中，19（70％）实现了妊娠，16（59％）自发妊娠。在40名ASA水平高的男性中，30（75％）实现了妊娠，16（40％）自发妊娠。Fisher精确检验P值为.2。
结论：ASA水平与输精管切除术逆转后的妊娠率或受孕方法无关。这些发现可以改善输精管切除术逆转前后的患者咨询。
