Objective      To investigate the patency rate and natural pregnancy rate after microsurgical vasoepididymostomy (MVE) and the effect of the anastomosis site on the patency rate in patients with obstructive azoospermia (OA).       Methods      Forty-four OA cases underwent MVE in our hospital from March 2012 to March 2014. The clinical data

intraoperative findings and postoperative follow-up results were collected

and the patency rate and natural pregnancy rate were statistically analyzed.       Results      The mean age of the 44 patients was 34.7 y

ears old (ranged from 20 to 58 years old). Thirty-nine cases underwent bilateral anastomosis

while 5 cases underwent unilateral anastomosis. The cases of anastomosis at the caput

corpus and cauda were 11

8 and 25

respectively. The average follow-up period was 9.57 months (ranged from 3 to 24 months). The total patency rate was 70.5% (31/44)

and the natural pregnancy rate was 22.7% (10/44). The sperm density was (0-42)×10

6

/mL [(13.97±13.07)×10

6

/mL

]

. The sperm motility was 0%-57% (A+B grade). The patency rates of the patients with bilateral anastomosis and unilateral anastomosis were 76.9% and 20%

respectively

while the natural pregnancy rates were 28.2% and 0

respectively. The patency rates of the patients with caput anastomosis

corpus anastomosis

and caudal anastomosis were 45.5%

75.0%

and 80.0%

respectively.       Conclusion      MVE is an effective approach for the treatment of OA caused by epididymis obstruction. The bilateral anastomosis and the caudal anastomosis may result in higher patency rate and natural pregnancy rate.