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Objective: To provide pregnancy and live birth rates from a contemporary series of vasectomy reversals in men with female partners aged ≥35 years and to correlate the results with IVF.Setting: Tertiary academic referral center.Design: Retrospective comparative study of prospectively collected database.Patient(s): Two hundred forty-six men who underwent vasectomy reversal for fertility with female partner aged ≥35 years.Intervention(s): Vasovasostomy or vasoepididymostomy.Main Outcome Measure(s): Correlation of pregnancy and live birth rate of this cohort by age groups with most recently published pregnancy and live birth rate per IVF cycle.Result(s): One hundred thirty-six men who underwent vasectomy reversal between 2006 and 2014 met our inclusion criteria. Overall pregnancy and live birth rates were 35% and 30%, respectively. Subgroup analysis by female age groups (35-37, 38-40, >40 years) demonstrated pregnancy and live birth rates comparable to those per IVF cycle by age groups according to a recently published (2015) national report.Conclusion(s): Vasectomy reversal should be strongly considered in men with a partner aged ≤40 years. Additionally, vasectomy reversal can be considered in carefully selected patients even with a partner aged >40 years. [ABSTRACT FROM AUTHOR]

Abstract: Civilisational clashes may be exacerbated by unconscious psychological projections, involving both national leaders and populations. In such cases emotional responses may override ‘rational’ behavior. Harmonic Circles is a deeply introspective Futures tool, and works with the human unconscious—the shadow. The purpose is to enable both parties in a ‘clash’ to assume greater responsibility for their mental and emotional states, with the goal of enhancing dialogue and healing. The mechanics and philosophy behind the tool are outlined (drawing upon psychological theories including depth psychology and transpersonal psychology). A hypothetical application is brought forward involving a possible civilisational clash between the United States and China. Finally, the further possible applications of Harmonic Circles are listed, including the strengths and weaknesses of the tool. [Copyright &y& Elsevier]