Fertility Options after Vasectomy

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Vasectomy is currently one of the most common methods of sterilization in the United States. After your vasectomy, if you change your mind about having children, there are two procedures that can help you have a child with your partner. The two options are: a vasectomy reversal or sperm aspiration prior to in vitro fertilization (IVF). Your doctor can help you choose which procedure is better for you and
your partner based on:
• How long it has been since your vasectomy
• Your age
• The number of children you want
• The cost
• How quickly you want to conceive a child, either naturally or through IVF Vasectomy
What are the first steps I should take?
The first thing to do is see a urologist. A urologist is a doctor who specializes in medical care of a man’s reproductive organs. Your urologist will take your medical history and do a physical examination to make sure you have no other health issues that would affect your fertility. Your partner should also see her doctor to make sure she has no fertility issues.
What happens in a vasectomy reversal procedure?
There are two types of vasectomy reversal procedures. The procedure used depends on the area
of the male reproductive tract that was blocked during your original vasectomy procedure.
• A vasovasostomy (vas-o-vay-ZOS-tuh-me) reconnects the two ends of the vas deferens. The vas deferens is a tube that transports sperm out of the testicle. You have two vasa deferentia, one each on both the right and left side of the scrotum. Each of the vasa deferentia was cut during your vasectomy to prevent sperm from mixing with semen.
• A vasoepididymostomy (vas-o-ep-ih-did-ih-MOS- tuh-me) reconnects the epididymis to the vas deferens. The epididymis is a coiled segment of the sperm ducts where sperm mature. This
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surgery is used when a vasovasostomy is not possible due to blockages caused by the vasectomy.
Your doctor will decide which procedure is better for you during the operation. Both types of vasectomy reversal may let you and your partner have a baby naturally through sexual intercourse.
How is sperm aspirated prior to an IVF cycle?
During this procedure, your doctor aspirates (gently suctions) sperm from your testicles. This procedure is usually performed under local anesthesia (with the use of numbing medication) in the office. It can also be done under general anesthesia (when you are put to sleep). A tiny needle is used to remove sperm directly from each vas deferens close to the testicle, or even directly from each testicle. Most men have some minor pain complaints after this procedure is completed.
The sperm is then used to fertilize your partner’s eggs in a laboratory by using IVF. The sperm can either be aspirated the day of the IVF procedure or it can be removed in advance and frozen for a future IVF procedure. Because the quantity of sperm is small, its use for artificial insemination is not recommended.
When this method is used along with IVF, it is highly successful, especially if your partner is under 35 years old. There are several other advantages to this method. It may mean that it will take less time for your partner to get pregnant and you won’t have to use birth control after a successful pregnancy. It is also a less invasive procedure for the male partner. There are some disadvantages as well. It is more expensive. If more than a single embryo is transferred, your partner may have more than one child at the same time. It is also a more invasive procedure for the female partner, and the procedure may have to be repeated if you want to have more children.
Revised 2011

For more information on this and other reproductive

health topics, visit www.ReproductiveFacts.org