Alternative Procedures to Vasectomy Reversal

For couples in their 30’s and older, surgical sterilization is the most common form of sterilization, but is there an alternative to expensive vasectomy reversal? Approximately 300,000 vasectomies are performed every year. However, due to the high incidence of couples divorcing and starting second, or even third families, 6-12% of men who have undergone a vasectomy request a vasectomy reversal. For many, either the costs associated or the prospect of more surgery is a deterrent, but until recently there were no alternatives to a vasectomy reversal.

Sperm Freezing

A man electing to undergo a vasectomy can be offered the option of freezing his sperm at the time of the procedure. This sperm can then be used in either artificial insemination or IVF. Research has shown the fluid that accompanies sperm is necessary for artificial insemination, therefore freezing the sperm ahead of time is a good choice for couples opting for artificial insemination as an alternative to vasectomy reversal.

ICSI

Since a vasectomy merely blocks sperm from the ejaculate, it is possible to retrieve viable sperm from the testes or epididymis. It is only the sperm which is retrieved, therefore this type of procedure is best suited to IVF or intracytoplasmic sperm injection (ICSI), in which the sperm is directly injected into a woman’s egg. There are several techniques that have been developed for reliable sperm retrieval, and this can be accomplished either through an incision or via a needle.

PESA and TeSA

Couples who are interested in a procedure providing enough tissue and sperm for a single cycle of IVF or ICSI can opt for a Percutaneous Epididymal Sperm Aspiration (PESA). In this procedure, a fine needle is passed through the scrotal skin and in to the epididymis, where a small amount of sperm is recovered. Occasionally, not enough sperm is recovered for use through this process.  A TeSA (Testicular Sperm Aspiration) can be used to aspirate both sperm and tissue, but usually not enough to freeze or use for more than one or two cycles.

A Vasectomy Reversal Alternative with a Better Return

Testicular Sperm Extraction (TeSE) and Microsurgical Epididymal Sperm Aspiration (MESA) are two procedures involving an actual incision and have been quite successful as an alternative to vasectomy reversal. These two processes often yield a better return of sperm, although the procedures are more invasive. Often, the tissue and sperm recovered through TeSE and MESA are enough to freeze for several attempts at IVF or ICSI should they be required.

Until recent times, men who have undergone a vasectomy often had no other choice than to try a vasectomy reversal in order to conceive children. Thanks to advanced technology and refined sperm retrieval procedures, it is now possible for a man to conceive a child without having to undergo the hours and expense of a vasectomy reversal. This is good news for couples who desire a family in spite of a decision that may been made before they even met.

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