Greetings and apologies for any cross-postings!

Preliminary results from a vasectomy study in seven countries show
conclusively that a surgical technique known as fascial interposition leads
to a more rapid decrease in sperm counts, which may improve the
effectiveness of some methods of vasectomy for male sterilization.  The
lower sperm counts occurred when fascial interposition was used with simple
ligation and excision.  The study was conducted by Family Health
International (FHI), based in Research Triangle Park, NC, and
EngenderHealth, based in New York, NY.  Details of the study will be
presented at the annual meeting of the Association of Reproductive Health
Professionals (ARHP), originally scheduled for September 12-15, but now
postponed to December 12-15, 2001.  For background information on vasectomy
methods and current research on vasectomy effectiveness, click here:
http://www.fhi.org/en/fp/fpother/conferences/vascet/vasectomymtg.html
<http://www.fhi.org/en/fp/fpother/conferences/vascet/vasectomymtg.html> .

"Individuals all over the globe want and rely on permanent methods of
contraception, making male and female sterilization the number one family
planning method in the world," maintains Amy E. Pollack, M.D., M.P.H.,
President of EngenderHealth.  "Therefore it is crucial that we perfect the
delivery of vasectomy services, as vasectomy is the only permanent method
available to men."

"This new study indicates that physicians providing vasectomy services
should consider modifying their technique," reports David C. Sokal, M.D.,
Associate Medical Director at FHI.  "Physicians who are currently practicing
simple ligation and excision should strongly consider modifying their
technique to include fascial interposition."

During the study, when fascial interposition was used along with ligation
and excision of the vas, about 93 percent of men had reached a low sperm
count (less than 100,000 sperm per milliliter of semen) by 22 weeks after
surgery, compared to 81 percent of men without fascial interposition.  Men
who have not undergone vasectomy typically have between 20 million and 150
million sperm per milliliter of semen.

Family planning handbooks typically describe vasectomy as nearly perfect,
better than 99 percent effective at preventing pregnancy.  However,
different ways of performing a vasectomy may result in slightly different
pregnancy rates.  This study did not look at pregnancy rates, but it is
likely that the risk of pregnancy would be higher among women whose partners
take longer to reach a low sperm count.  It is estimated that only about 10
percent of vasectomies in the United States are done using simple ligation
and excision, but that this method is much more commonly used in developing
countries.

Some experts believe that cautery (burning the vas) may be the most
effective vasectomy occlusion technique, with or without fascial
interposition.  However, using cautery requires special equipment which
might not be practical in low-resource settings.  FHI and EngenderHealth are
currently planning studies to evaluate cautery techniques for use in
low-resource settings.

Various vasectomy methods and recent research on vasectomy effectiveness
were discussed at a meeting of experts, co-sponsored by Family Health
International and Engender Health, April 18-19, 2001 in Durham, NC.  A
summary of the meeting can be found at the URL listed above.

Beth Robinson, Associate Director for Information Programs, Family Health
International
E-mail: [log in to unmask] <mailto:[log in to unmask]>
Telephone: (919) 405-1461

Carrie Svingen, Communications Manager, EngenderHealth
Email: csvingen@engenderhealth <mailto:csvingen@engenderhealth>
Telephone: (212) 561-8538