Non-surgical reversal of vasectomy.

A biopsy device originally designed to obtain samples of prostate tissue has been modified to retrieve sperm from the testicles, allowing vasectomized men to father children without having to undergo surgery. It also can be used to restore fertility to men with reproductive abnormalities, indicates Harry Fisch, director of the Male Reproductive Center, Department of Urology, Columbia-Presbyterian Medical Center, New York, who helped design the device.

Each year, about 500,000 American men have vasectomies, a minor outpatient surgical procedure in which the vas deferens -- slender tubes that carry sperm from the testicles to the penis -- are cut and then sealed with clips or sutures. "Growing numbers of men are now requesting vasectomy reversals, usually to start new families after remarriage following a divorce of the death of a spouse." However, reversals, called vasovasostomies, are much more complex than vasectomies since microsurgery is required to reattach the vas deferens, a delicate process that usually requires general anesthesia and that can take two to three hours or longer, if blockages are found.

The pregnancy rate following vasovasostomy varies significantly, depending primarily on the interval between the vasectomy and the reversal. "The longer you've had a vasectomy," explains Fisch, "the higher the likelihood of a blockage in the epididymis," the sacs where sperm are stored, just above the testicles. Three years post-vasectomy, the pregnancy rate is 76% and it steadily declines to 30% after 15 years.

Because of vasovasostomy's...