European countries have different rates of sperm cryopreservation before vasectomy and at the time of reversal

Amandine Degraeve (1) , Thierry Roumeguere (2) , Gilles Tilmans (1) , Marie Laura Marotta (1) , Éric Huyghe (3, 4) , Georges Fournier (5) , Antoine Faix (6) , Anne Françoise Spinoit (7) , Karel P.J. Decaestecker (7) , François Herve (7, 8) , Florence Boitrelle (9, 10, 11) , Kanerva Lahdensuo (12, 13) , Julien van Damme (1)

1 UCL - Université Catholique de Louvain = Catholic University of Louvain
2 ULB - Université libre de Bruxelles
3 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
4 DEFE - Développement Embryonnaire, Fertilité et Environnement
5 CHU - BREST - Urologie - CHRU de Brest, service de chirurgie urologique et de la transplantation reinale
6 Clinique Beau Soleil [Montpellier]
7 Ghent University Hospital
8 Cliniques Universitaires Saint-Luc [Bruxelles]
9 BREED - Biologie de la Reproduction, Environnement, Epigénétique & Développement
10 CECOS - Centre d’Études et de Conservation des Œufs et du Sperme [CHU Jean Verdier]
11 Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy]
12 TKK - TKK Helsinki University of Technology
13 HUS - Helsinki University Hospital [Finland]

Effective male contraceptive options are condoms and vasectomy. Vasectomy should not be considered a reversible method of contraception even if vasovasostomy can be offered to men to restore fertility after vasectomy. Therefore, there is a real questioning among urologists concerning cryopreservation before vasectomy. We carried out an international survey concerning the practice of cryopreservation before vasectomy and during vasovasostomy. Material and methods: An online anonymous survey was submitted from January to June 2021 to six European urological societies. The 31-items questionnaire included questions about demography, habits of cryopreservation before vasectomy or during vasectomy reversal, and in case of urogenital cancers. Results: 228 urologists from six urological societies in five different countries (Belgium, Netherlands, Luxembourg, France, Finland) answered the questionnaire. French urologists were more in favor of cryopreservation before vasectomy than other European urologists (p < 0.0001). They also significantly found that not talking about cryopreservation before vasectomy is a medical fault unlike other urologists (p < 0.0001). The specialization in andrology did not influence the choice of cryopreservation before vasectomy (p = 0.9452). The majority of urologists did not perform intraoperative sperm extraction during vasovasostomy (81%; n = 127) with a significant difference between urologists with or without andrology training (p = 0.0146). Success rates after vasovasostomy are significantly better for robot-assisted surgery (p = 0.0159) or with a microscope (p = 0.0456) versus without a microscope. Conclusion: Cryopreservation before definitive sterilization significantly varies among European urologists and seems to be mostly dictated by habits than by knowledge. An international consensus is needed to standardize practices and guide patients’ choices.

Mots clés: cryopreservation; definitive sterilization; male contraception; vasectomy; vasectomy reversal

Domaines: Sciences du Vivant [q-bio]

Amandine Degraeve, Thierry Roumeguere, Gilles Tilmans, Marie Laura Marotta, Éric Huyghe, et al.. European countries have different rates of sperm cryopreservation before vasectomy and at the time of reversal. Andrology, 2022, 10 (7), pp.1286-1291. ⟨10.1111/andr.13182⟩. ⟨hal-03837195⟩