An alternative to vasectomy reversal is sperm retrieval with IVF/ICSI in couples who desire to get pregnant after a vasectomy procedure. This is an ideal choice for couples in whom there are significant female factor infertility issues such advanced maternal age (>40 years old). In theses cases, In Vitro Fertilization may be required to get pregnant and a simpler approach is to remove some sperm from the epididymis or testis and use this for IVF with ICSI.
Oftentimes, a couple will request sperm retrieval to be performed with Intra Uterine Insemination (IUI) as this is not very invasive and appears to be the least costly alternative for getting pregnant after a vasectomy. IUI procedures can ONLY be performed with fully mature sperm from the ejaculate and the success is highly dependent on having adequate numbers of motile sperm present (>10 million). Unfortunately, sperm retrieved from the epididymis and testicle is not mature enough or adequate in quantity to get pregnant with this form of assisted reproduction. In fact, attempts at even performing conventional In Vitro Fertilization with testicular or epididymal sperm have been met with such poor success that most IVF centers today will only perform the more sophisticated Intra Cytoplasmic Sperm Injection (ICSI) procedure in cases where epididymal or testicular sperm is present, as is always the case after a vasectomy.
When choosing a surgeon for your sperm retrieval, make sure that your surgeon specializes in all of the various techniques described for sperm retrieval. Some men will require a simple percutaneous sperm retrieval, whereas others might require the more sophisticated technique of microdissection TESE. A male infertility specialist will ensure that an adequate amount of sperm will be procured for multiple cycles if IVF, if necessary.
