Reversing Vasectomy: Benefits
The benefits of having a vasectomy reversal are best understood when one understands the alternatives to having a vasectomy reversal.
Most men who wish to have their vasectomy reversed do so because they desire to have more children. Others may do so for religious reasons or for treatment of Post Vasectomy Pain Syndrome.
If you have had a vasectomy, change your mind, and would like more children then there are only two options which will allow you to have children that are genetically your own:
- Assisted reproductive technology
- Vasectomy reversal
There are two additional options for more children after vasectomy: adoption or using sperm donated from another male to cause pregnancy. Often men want to father their own children and, as a result, these two additional alternatives are often seen as less desirable.
Option 1: Assisted reproductive technology
Assisted reproduction technology can allow couples who have tubal blockage to have more children by by-passing the blocked tubes. This technology can be used by couples to overcome infertility when a man has had a vasectomy, when a woman has had a tubal ligation, or when both man and woman have had sterilization procedures.
If the male partner has had a vasectomy then the assisted reproductive techniques which must be utilized are percutaneous sperm aspiration (PESA) and in-vitro fertilization (IVF).
Even after a vasectomy, sperm is continually being produced in the epididymis. The vasectomy simply blocks the transport pathway of sperm from the epididymis to the seminal vesicles. Since sperm are required to father a child genetically similar to the male partner, sperm have to be actively retrieved from epididymis to cause pregnancy. The procedure to retrieve sperm from the epididymis is Percutaneous Epididymal Sperm Aspiration (PESA).
PESA can be performed in an office under deep IV sedation or local anesthesia. To obtain sperm, the doctor inserts a needle into the epididymis and aspirates (removes) sperm from the epididymis where they are being produced. This procedure can only produce enough sperm to be used for in-vitro fertilization. Depending on the amounts of sperm retrieved, extra sperm can be frozen and used for future IVF cycles.
Men who are considering PESA should be aware the procedure can be very effective at retrieval of live sperm. Men should also be aware the procedure is often uncomfortable and the cost can range from $2,000 to $9,000. There will be additional charges for freezing and storage of any extra sperm.
PESA can be a traumatic to the delicate tubules of the epididymis and can cause multiple secondary blockages in the epididymis. This may decrease the success of any future vasectomy reversal procedure.
Unfortunately after a vasectomy, sperm cannot be retrieved in large enough amounts to allow for multiple intrauterine insemination (IUI) attempts.
IUI is a procedure in which a doctor will insert sperm into the women's uterus during the time of ovulation. This is often easier and much more affordable than IVF but it requires sperm in high numbers to be effective. Also IUI may have to be repeated over several monthly treatments to result in pregnancy.
IUI cannot usually be used when the male partner has had a vasectomy unless than man has had a vasectomy reversal.
After vasectomy reversal and if sperm is being produced in sufficient enough numbers, the sperm can be collected and concentrated for IUI treatments if natural pregnancy is not occurring after reversal.
Even if the female partner has normally functioning fallopian tubes, she will need to have in-vitro fertilization treatment to become pregnant.
During in-vitro fertilization, the woman is injected with high dose hormones which will cause the formation of multiple eggs. The eggs are then retrieved under deep intravenous sedation by inserting a needle into the vagina under ultrasound guidance. The goal is to retrieve as many eggs as possible. Once these eggs have been removed from the body they are then combined with the sperm which have been obtained by the PESA procedure outlined above.
The sperm and eggs are then combined in a controlled environment (incubator) to allow fertilization. If the amounts of sperm obtained from the PESA procedure are low then many infertility experts will also recommend treatment with intra-cytoplasmic sperm injection (ICSI) to increase the chance of fertilization.
The ICSI procedure requires the DNA of the sperm be injected directly into the egg with a small needle to increase the chance of a egg fertilization.
If any eggs successfully fertilize they are then observed to see which ones are actively growing. Those that are considered the most healthy are then inserted into the woman's uterus in the hope they will attach and begin growing.
The cost for a single cycle of IVF in the United States ranges from $10,000 to $14,000. A single cycle of IVF with PESA will range in cost form $12,000 to $23,000. If ICSI is required then the cost will be more. If pregnancy does not occur with the first IVF cycle then the IVF cycle must be repeated at an additional cost. PESA may or may not be repeated depending on how much sperm was retrieved with the initial PESA procedure.
The average pregnancy success of a single cycle of IVF is 38%. It is generally recommended that couples considering IVF be prepared to attempt at least three (3) cycles to obtain a successful pregnancy.
The single most predictive factor of IVF success is the age of the female partner. In general success based on the female partner's age is:
- female less than 30 years of age: 50% chance of IVF pregnancy success
- female between 30 and 40 years of age: 35% chance of IVF pregnancy success
- female partner over 40 years of age: less than 25% chance of IVF pregnancy success
Option 2: Vasectomy reversal
Vasectomy reversal is a surgical procedure in which the vas deferens are rejoined. The procedure is often performed as an outpatient surgery, in under three (3) hours, and requires two (2) to four (4) days off from work. Vasectomy reversal can restore the presence of sperm in the ejaculate and allow the chance of natural pregnancy.
The success of vasectomy reversal depends primarily on the length of time since the vasectomy was performed. In men who have their vasectomy reversed in less than three (3) years after having their vasectomy, the success of the reversal can be as high as 97%. In men who wait longer the success of reversal can be as high as 69%. On average vasectomy reversal is approximately 85% successful in returning live sperm to the ejaculate.
The average cost of vasectomy reversal in the United States ranges from $6,000 to $14,000.
Benefits of vasectomy reversal
The main benefit of vasectomy reversal is it allows couples the chance to become naturally pregnant. Not only does vasectomy reversal allow couples the chance to become pregnant again, but it allows couples the ability to do so without multiple doctor’s visits and costly medical treatments.
Even if vasectomy reversal results in return of sperm in low numbers then monthly IUI may be an alternative to IVF if the woman does not have tubal blockage or other infertility issues.
The restoration of fertility allows the chance of pregnancy every month. Over time these monthly chances can add up and provide more of a chance than can a single cycle of IVF.
Benefits of vasectomy reversal
The main benefit of vasectomy reversal is the procedure allows you to avoid the more costly alternatives of reversing vasectomy.