There are two options available to couples who find they want to conceive using their partner’s sperm after the male has undergone a vasectomy: TESE/PESA (Vasectomy Reversal) and In-vitro Fertilization (IVF) with Intracytoplasmic Sperm Injection (ICSI). Several variables should be considered as a couple decides whether vasectomy reversal or IVF with ICSI is their best treatment option. These include the amount of time passed since the vasectomy and the reproductive age of the female partner,
Vasectomy Reversal
A vasectomy reversal is performed by rejoining the ends of the vas deferens through a procedure called Vasovasostomy or by connecting the vas deferens to the epididymis via the procedure Vasoepididymostomy. Vasectomy reversals are most successful if completed within the first 7 years of having the vasectomy. After 5-7 years, vasectomy reversal success rates plummet due to various factors that include sperm antibody formation, tagging sperm that interfere with natural fertilization of egg and impair motility of sperm. Other factors that can also contribute to infertility include: epididymal dysfunction or blocking of the vas deferens due to scar tissue. Moreover, a successful vasectomy reversal does not ensure a couple will have a successful pregnancy. The female partner should check her fertility with a Reproductive Endocrinologist before the male partner proceeds with a vasectomy reversal (i.e. HSG, AMH).
Needle Aspiration of Sperm
With epididymal/testicle sperm aspiration (ie: PESA/TESE) the cost is 1/5 less than a typical vasectomy reversal, contraception remains intact, and can be combined with the IVF process with noted less pain. Then, directly injecting the sperm into the egg with IVF/ICSI eliminates the need for sperm binding allowing the couple to conceive even when there is a low sperm count, poor motility or physical blockage. Furthermore, IVF with ICSI is ideal when considering the reproductive health of both partners.
Advantages to IVF with ICSI:
- IVF with ICSI offers a shorter wait time before a couple can try to conceive. A couple may try immediately with IVF once the sperm extraction has been performed. This is much faster than a vasectomy reversal, IVF with ICSI will address many female infertility issues the couple may have
- IVF with ICSI is a better option for women who have a limited window of time due to advanced reproductive age
- IVF with ICSI leaves the contraception intact for couples who only want one childIn summary, there are always choices, but it’s important to discuss all these points, along with the couples’ medical history, with a Reproductive Endocrinologist. At Brown Fertility, we can assess both partners and give advice on which option will give the best chance of a successful pregnancy.
Contact online or call our caring staff at Brown Fertility as you consider all the variables of whether a vasectomy reversal or IVF with ICSI is your best treatment option.