Factors to consider for informed consent prior to vasectomy reversal.

sperm heads and short tails), a TESE could be performed for the express purposes of cryopreservation. Indeed, in selected patients, discussion of concurrent VR coupled with sperm harvest for IVF could be the preferred option, especially given that costs for sperm harvesting as an isolated procedure can sometimes approach those for a VR.5 Partner’s age is another critical discussion point in preoperative consultations. A proper informed consent should also include discussions on partner age and the fact that pregnancy rates in female partners >age 40 years tends to drop precipitously.6 As such, options such as IVF may be preferred in some patients in whom time is of the essence. Another interesting point for discussion includes that, in most cases, prevasectomy semen analysis remains unknown. Thus, the surgeon is left with the WHO population standards for semen analyses’ guidelines postrepair, when some patients may never have been at these levels prior to vasectomy. While VR has been an accepted and very successful modality for achieving fertility, practice patterns continue to evolve. Nevertheless, whatever the means of fertility attainment, the primary goal should always remain the desire to produce a live, healthy offspring for our patients, no matter what the technique employed.