You underwent a vasectomy thinking you never want to get another woman pregnant, but then again, the circumstances changed. Reversal of the surgery is possible but it may or may not bring the desired results, which is why IVF after vasectomy is generally recommended to the men planning parenthood again.
What is Vasectomy?
A vasectomy, also called the snip, is a minor surgical procedure which acts as a permanent form of contraception. During a vasectomy, the tubes linking the testes to the urethra—the vas deferens—are cut and tied, thereby preventing sperm from leaving the testes.
Pregnancy after Vasectomy
A vasectomy is considered to be a very reliable way of preventing pregnancy; instead of relying on contraceptives (and dealing with their side-effects), the men can simply undergo this procedure for male sterilization.
According to data from the National Survey of Family Growth, every year over 500,000 men in the US undergo vasectomy.
Couples are usually advised to consider the option of a vasectomy carefully before making their decision, as even though there are options to reverse the procedure, future pregnancies will be much more difficult to achieve.
Sometimes, after undergoing a vasectomy, a man can realize he is very keen to have a baby again. It could be because of remarriage after divorcing your current partner, the death of a wife or child, or a renewed desire to expand your family.
Even though vasectomy reversal is possible; it may not always work.
When does vasectomy reversal not work?
The surgery and its subsequent reversal may leave scar tissue in the vas deferens, which could obstruct with the sperm passage even after the tubes are rejoined.
There is another reason why vasectomy reversal may not be a good idea. The Hospital Corporation of America explains that the testicle continue to procedure sperm even after the initial vasectomy. Since that sperm is not being transported outside, it could be mistaken as foreign object and attacked by the body’s immune system.
So vasectomy reversal will not be useful if your own body has decided to destroy your sperm.
In this case you could go for surgical sperm extraction followed by IVF. A technique called testicular sperm aspiration (TESA) allows the sperm to be removed directly from your testes, which is then used to fertilize the female egg.
Procedure of IVF after vasectomy
Sperm retrieval after vasectomy
There are different techniques that may be used to retrieve sperm directly from the testes following a vasectomy. All of these techniques are relatively straight forward and only require local anaesthetic or sedation.
They may be performed in either your doctor’s office or an operating room. The main difference between these techniques is the site from which the sperm is retrieved.
1. PESA (Percutaneous Epididymis Sperm Aspiration)
A needle attached to a syringe is passed into the epididymis (a tube behind the testes that carries sperm). Sperm is then aspirated directly from here.
2. TESA (Testicular Sperm Aspiration)
A needle attached to a syringe is passed through the scrotum and sperm is aspirated directly from the testicle.
3. TESE (Testicular Sperm Extraction)
This is slightly different to the other two aspiration techniques as it involves taking a small biopsy of tissue from the testicle. This tissue is then processed in a laboratory, in order to extract the sperm cells. This is usually performed if no sperm was retrieved using PESA or TESA.
ICSI technique, followed by IVF
Once the sperm has been retrieved from the testes, it can be injected into eggs which have been retrieved from the female partner in a technique known as ICSI.
This fertilized egg will then be cultured for between 3 and 5 days and the resulting embryo will be transferred back into the female’s womb, in the process of IVF.
Cost of IVF after a vasectomy
IVF is an expensive process and all additional treatments come with added expenses. ICSI can add on up to $1,500 to the cost of your IVF treatment, while sperm retrieval can cost around $2,000 when taking into account sperm freezing, anesthesia, operating room charges, etc.
Whilst the cost of treatment can vary significantly depending on the country and clinic that you decide upon, the costs of IVF, ICSI and sperm retrieval are considerably lower in countries like Thailand, Malaysia, Spain, Mexico, India, etc.
Chances of success of IVF after a vasectomy
As a vasectomy should cause no damage or changes to sperm quantity or quality, your chances of success with ICSI/IVF should be just as high as prior to your procedure. At a good IVF clinic, the fertilization rate following ICSI treatment is typically between 70% and 80%.
IVF success is comparable to that of natural, spontaneous conception. Research shows that testicular sperm extraction is a safe and effective method of sperm retrieval and the pregnancy rates achieved by using such sperm in IVF are similar to those of other IVF cycles.
Alternatives to IVF after Vasectomy
IVF after a vasectomy ensures the contraceptive value of the vasectomy remains and can help to overcome any issues with female fertility as well.
The downside is the high cost of treatment, the invasive nature of the procedure, and the side effects of the associated medication.
There are a few alternatives to undergoing traditional IVF treatment following a vasectomy. These include:
1. Vasectomy reversal
This is a surgical procedure whereby the vas deferens is reconnected. This procedure is fairly complicated and is not guaranteed to work. It would also mean that you would need to use other forms of contraception in the future.
Also, as explained above, vasectomy reversal may not always bring the desired results.
2. Sperm retrieval with IUI
This is less invasive than IVF treatment; however, you need to have retrieved a good quantity of fully mature sperm to have a chance of success with IUI.
3. IUI with donor sperm
This presents a viable option. However, the obvious drawback to this is that the male partner would not be biologically related to the child.
It is very important to research carefully into all of your options before making a final decision. You should take into account, your particular circumstances as well as the fertile health of both you and your partner.
If you plan to undergo IVF after vasectomy, it is imperative you discuss in detail with your fertility specialists.