Vasectomy Reversal Vs IVF
Vasectomy reversal or IVF ?
If you plan to have a child (or children) after a vasectomy you have two main choices: Vasectomy reversal or IVF (in vitro fertilisation).
The decision for vasectomy reversal or IVF depends on your individual circumstance.
If you do not reverse your vasectomy sperm can be surgically removed from your testes or epididymis. These sperm are never numerous enough to achieve pregnancy except through IVF.
For most patients a vasectomy reversal procedure is a better first option than IVF as it provides a higher overall chance of pregnancy and gives you the widest range of options in the future.
Importantly:
The surgical sperm retrieval required for IVF reduces the chance of success of a future vasectomy reversal surgery
Vasectomy reversal can simplify and optimise the prospect of future IVF if needed
IVF with surgical sperm extraction can reduce future vasectomy reversals success because sperm extraction damages either the epididymis (which is a continuation of the vas deferens into the testis) or the sperm collecting system inside the testis (the rete testis).
On the other hand, should vasectomy reversal not work for any reason (no sperm, not enough sperm, poor sperm or no pregnancy despite sperm), there is nothing about vasectomy reversal that limits the future success rate of IVF. As most men who undergo vasectomy reversal have sperm present in the semen, they will not need a sperm retrieval procedure should IVF be needed later.
IVF with sperm extraction
IVF involves the use of hormone medications to stimulate the growth of multiple eggs in one cycle. A woman’s ovarian response to these drugs is monitored with blood tests and ultrasounds. Once eggs are mature they are removed from the ovaries by aspirating ovarian fluid using a needle inserted from the vagina into the ovary under ultrasound guidance by a Fertility Specialist (with a light anaesthetic – the patient will not feel it).
The fluid is examined for eggs. If you have had a vasectomy, sperm are retrieved from you through a needle sperm aspiration of the epididymis (PESA), a needle aspiration of the testis (TESE) or an open biopsy of the testis. The eggs are injected with the sperm aiming to produce embryos. A single embryo is then placed back into the uterus five days after the egg collection procedure and the couple then wait another 10 days to determine if the treatment has resulted in pregnancy.
For many IVF is an appropriate treatment with a good chance of success. However, when a prior vasectomy has been performed consideration needs to be given to whether a vasectomy reversal or IVF is undertaken first.
Vasectomy Reversal vs IVF Cost
While the reversal of vasectomy cost (out of pocket) is as little as $4,700, IVF costs are harder to predict – both because of clinic variations but also because you cannot know how many cycles will be needed to achieve a pregnancy. Unless IVF achieves a pregnancy quickly vasectomy reversal will usually cost less. This may be particularly so if you are planning more than one child after your vasectomy reversal.
Vasectomy reversal is usually the more affordable option when it comes to addressing fertility issues. Vasectomy reversal success rates over time are usually higher than IVF success rates. Clearly there is a chance of pregnancy every ovulation after vasectomy reversal whereas additional IVF will involve further procedures. The extra, hidden cost of travel to clinics for procedures and monitoring can make IVF particularly expensive for rural patients.
Overall, when it comes to vasectomy reversal vs IVF cost vasectomy reversal is usually less costly. If vasectomy reversal is unsuccessful the option of IVF remains, and IVF success rates are either not affected or may even be improved (as fresh ejaculated sperm may be used) after a vasectomy reversal.
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