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首页> 外文期刊>Current Surgery >Vasovasostomy: multiple children and Long-term pregnancy rates.
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Vasovasostomy: multiple children and Long-term pregnancy rates.

机译：输精管吻合术：多胎和长期妊娠。

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PURPOSE: To determine the long-term patency and pregnancy rates after vasovasostomy and to determine the likelihood of having more than 1 child after this procedure. MATERIALS AND METHODS: We performed a retrospective examination of 73 patients that were at least 4 years out from vasovasostomy at our institution. Patients and their partners completed questionnaires that focused on their pre- and post-procedure fertility, vasal obstructive interval, time to pregnancy, and the number of children conceived. All patients were asked to obtain a current semen analysis. RESULTS: From a population of 73 patients with proven prior fertility, 43 could be contacted for data collection. Of the 43 men, 39 (91%) reported that they had actively tried to father children. These 39 men are a mean of 84.8 months (range, 4 to 10 years) out from their surgery, with a mean vasal obstructive interval of 87 months (7.4 years). All men denied using assisted reproduction techniques except the father of the only twins, who reported the use of ICSI for female-factor infertility. He was excluded from further pregnancy calculations. Forty-five percent of couples achieved at least 1 pregnancy, whereas 6 of 17 (35%) conceived 2 children. Mean time to conception was 14.7 months for the first child and 51 months for the second (range, 13 to 108 months). In those that did not conceive (n = 21), the mean obstructive interval was 106 months versus 81 months for those that did conceive. This time interval was not statistically different (P > 0.05). Mean maternal age was significantly less in those that did versus those that did not conceive (32.2 vs 36.6 years) (P < 0.01). We also noted that 10 of 21 were with a different spouse that had never been pregnant. Three of these 10 had known female-factor fertility problems. Semen analyses were obtained in 6 of the 21 patients that did not father children. Only 1 of the 6 was azoospermic. Thirteen (33%) desired more than 1 child at the time of vasectomy reversal. CONCLUSIONS: After vasovasostomy in patients with a vasal obstructive interval of 7 years, up to 45% of couples may achieve pregnancy and up to 35% could go on to conceive a second child. Long-term anastomosis patency after the procedure is estimated to be approximately 60%. Maternal age is a significant factor in predicting a couple's success in conceiving a child. Vasovasostomy remains a highly effective option for restoration of fertility in vasectomy patients, while offering the opportunity for multiple pregnancies with only a single intervention.
机译：目的：确定输精管吻合术后的长期通畅率和妊娠率，并确定此手术后多于一个孩子的可能性。材料与方法：我们对本机构接受血管吻合术至少4年的73例患者进行了回顾性检查。患者及其伴侣完成了针对他们的手术前和手术后生育能力，血管阻塞间隔，怀孕时间和受孕孩子数量的问卷。要求所有患者获得当前的精液分析。结果：从73名先验有生育能力的患者中，可以联系43名进行数据收集。在这43名男子中，有39名（91％）报告说，他们曾积极尝试过生孩子。这39名男性患者平均离手术时间为84.8个月（范围为4至10年），平均血管阻塞间隔为87个月（7.4年）。除唯一一对双胞胎的父亲外，所有男人都拒绝使用辅助生殖技术，他们的双胞胎报告了将ICSI用于女性不育症。他被排除在进一步的妊娠计算之外。 45％的夫妇至少怀孕1次，而17人中有6人（35％）怀孕了2个孩子。第一个孩子的平均受孕时间为14.7个月，第二个孩子为51个月（13到108个月）。在未受孕者中（n = 21），平均梗阻间隔为106个月，而未受孕者为81个月。该时间间隔在统计学上没有差异（P> 0.05）。有孕和无孕的平均产妇年龄要低得多（分别为32.2和36.6岁）（P <0.01）。我们还注意到，在21人中有10人的配偶从未怀孕。这10人中有3人知道女性因素导致的生育问题。精液分析是在21例没有生孩子的患者中进行的。 6个中只有1个是无精子的。输精管切除术时，有十三名（33％）希望多于一名儿童。结论：输卵管阻塞间隔为7年的患者在进行了输卵管吻合术后，多达45％的夫妇可能会怀孕，而多达35％的夫妇可能会继续生下第二个孩子。手术后的长期吻合术通畅率估计约为60％。产妇年龄是预测夫妻成功怀孕的重要因素。输精管吻合术仍然是输精管切除术患者恢复生育能力的高度有效的选择，同时只需一次干预即可提供多次妊娠的机会。

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