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4everhopeful - July 20th, 2006 6:51 AM

Dear Dr Smith :)

I've just read this article http://www.ivf.net/content/page-o2100.html which has really worried me!

My husband had a vasectomy in 1999 and a reversal op in 2002, so didn't have the vasectomy in place for very long. We are lucky in that he still has sperm present, though he still has a fair bit of aggultination.

As you know, we've had 3 ICSI failures so far, but after discovering I had blood clotting probs and ANA's, I'd asumed it was all down to me, as to why we haven't had any luck so far...
But now I'm really worried that his sperm could be defective because of the vasectomy :-\ Between us, I'm worried that we are a hopeless case :-\

We're due to start our 4th ICSI cycle next month... Is there any way we can find out whether his sperm have been damaged as a result of the vasectomy?

He's now taking proxseed, multi vits to boost fertility, and has stopped drinking any alcohol (which is tough for him, coz he's really missing his nightly tipple of brandy and coke!) Is there anything else we can do to boost the quality of his sperm?

Many, many thanks for all your help ;D

Nat :)

Dr Smith - July 20th, 2006 12:36 PM

Well... The first thing to consider is that this data was presented in abstract form to the society (ESHRE) and has not undergone the peer review process necessary for publication in a reputable journal. And it has not been confirmed by other researchers. It does, however, make for sensational news copy. I have been to meetings and read abstracts of studies that were based on a very small number of patients and/or were serious flawed in experimental design, only to find the study quoted in some sensational news article that was written by a "medical journalist" with no medical or scientific training.

Another other thing to consider, given that the data is reliable, is that the genetics of the sperm improved with time after the reversal. Since its been 4 years since the reversal, things may be back to the way they were before the vasectomy.

Finally, there is a significant amount of backgroud "noise" in sperm genetics, with significant day to day variation in quality. The genetics of the sperm sample are likely to change from day to day.

There is no clinical test available to determine aneuploidy in sperm and it wouldn't necessarily be predictive of a subsequent sperm sample anyway. I wouldn't worry too much.


4everhopeful - July 21st, 2006 8:17 AM

Thank you for setting my mind at rest Dr Smith :)

When I read something like that on the internet, especially when it's something negative (!) I tend to take it as gospel! ::) I didn't realise that the findings of this study have yet to be formally verified...

The only part of the study that gave me a glimmer of hope, was the fact that it said the gentetics of the sperm can improve over time... Fingerscrossed this will be the case with my hubby, especially as, like you say, it's been 4 years since he had the reversal, so hopefully it'll be 4th time lucky for us!

Many thanks,

Nat :)

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