HEMIZONA ASSAY - EVALUATION OF FERTILITY POTENTIAL IN PATIENTS WITH VASECTOMY REVERSAL

Approximately 40 to 60% of men who undergo a successful vasovasostomy have ''functional failure'' or failure to conceive even though active sperm are present. Factors of this functional failure include sperm ab normalities (oligoasthenoteratospermia) and antisperm antibodies. Nine male patients 32 to 43 years of age who underwent vasovasostomy were included in the study group. These patients demonstrated ductal patenc y 3 to 6 months after surgery. After attempts at fertility with their spouses failed, the couples underwent urological and gynecological eva luation. Semen parameters were recorded and further evaluation was per formed using immobilizing and agglutination antibodies as well as dire ct immunobead test and the hemizona assay (HZA). Semen parameters pres ented varying levels of sperm concentration, percent motility, and mor phology (strict). Antisperm antibodies were present in 4 of the 9 pati ents. Three of 4 patients with antibodies and 4 of 5 patients without antibodies benefitted from hemizona assay results in that it either su pported a desired therapy or gave objective data that would dictate mo re aggressive therapy. Six men had a hemizona index of >35%, predictiv e of adequate zona binding capability. Using these individual situatio ns combined with gynecologic findings, recommendations are made as to identifying realistic options and therapeutic recommendations.