Vasectomy and vasectomy reversal: a comprehensive approach to the evolving spectrum of care

Male reproduction and male contraception form an important spectrum within men’s health. In this issue’s Views Reviews, four author groups detail new developments in vasectomy clinical practice guidelines, emerging investigational techniques the fields of hormonal nonhormonal contraception, useful paradigms for patient care when deciding between sperm extraction with vitro fertilization reversal, finally, a state-of-the-art overview recent reversal microsurgery. These articles will provide readers contemporary understanding rapidly evolving reproductive contraceptive health care. restoration fertility after surgical are two major drivers patients’ engagement system. Many have occurred along years, it is clinicians to be familiar these advances optimal guidance patients their partners as they consider therapeutic options. The purpose series Reviews update on progress made areas thus facilitate ability most effectively guide throughout journeys. Velez, Pagani, Mima, Ohlander coauthored first piece clear informative article entitled “Vasectomy: A Guidelines-Based Approach Surgical Contraception.” authors key considerations from American Urological Association guidelines other sources vasectomy, including counseling, technical aspects procedure, postvasectomy (1Sharlip I.D. Belker A.M. Honig S. Labrecque M. Marmar J.L. Ross L.S. et al.Vasectomy: AUA Guideline.J Urol. 2012; 188: 2482-2491Crossref PubMed Scopus (114) Google Scholar). address knowledge gaps commonly found among providers area updated, streamlined approach that clearance forego forms abundance literature showing well tolerated, minimal pain very low rates postprocedural complications. next article, by Amory Thirumalai, “Emerging Approaches group University Washington long been cutting edge which include both approaches (2Amory J.K. contraception.Fertil Steril. 2016; 106: 1303-1309Abstract Full Text PDF (29) expertly provided comprehensive experimental field, show androgen/progestin combination compounds topical gels currently hold promise successful translational application men. contrast, although numerous also studied preclinical trials, human data assessing safety efficacy lacking at time. options seem further potential translation than approaches. Dubin, White, Ory, Ramasamy third contribution, “Vasectomy Reversal Versus Sperm Retrieval IVF: Contemporary, Comparative Analysis.” Approximately one half million men choose undergo annually, approximately 6% pursue conception undergoing procedure (3Haws J.M. Morgan G.T. Pollack A.E. Koonin L.M. Magnani R.J. Gargiullo P.M. Clinical vasectomies performed United States 1995.Urology. 1998; 52: 685-691Abstract (53) Scholar, 4Sandlow J.I. Westefeld J.S. Maples M.R. Scheel K.R. Psychological correlates vasectomy.Fertil 2001; 75: 544-548Abstract (34) Counseling can challenging requires firm main couples from, namely, use cases fertilization. done outstanding job delineating parameters must take into account counseling couples, duration obstructive interval, female factor issues, ages partner, insurance coverage, many others. thoughtfully sometimes conflicting competing concerns, providing paradigm effective shared decision-making. This collaborative essential helping navigate complexities options, vs. last Fantus Halpern, “Vasovasostomy Vasoepididymostomy: Indications, Operative Technique, Outcomes.” microsurgical specialists outcomes (5Halpern J.A. Brannigan R.E. Schlegel P.N. Fertility-enhancing surgery: glimpses past thoughts future.Fertil 2019; 112: 426-437Abstract (6) preoperative assessment, operative vasovasostomy vasoepididymostomy, postoperative care, complications, outcomes. serve resource who perform procedures those do not but wish enhance current state reversal. Our hope help reach Up-to-date familiarity nuances through decision-making process. point additional study hypothesis-driven research needed increase optimize