Can I Use Testicular Sperm Retrieval for IVF After Vasectomy?

Hello, doctor?

Hello doctor, I have a question: I had a vasectomy three years ago, and I recently remarried and would like to have children again.
Besides having a vasectomy reversal (which seems to have a low success rate and is complicated), is it possible to extract sperm from the testicles using a needle for my wife to undergo in vitro fertilization? Thank you for your response.

Li, 30~39 year old female. Ask Date: 2002/06/27

Dr. Chen Zhihong reply Urology

The success rate of vasectomy reversal (using microsurgical techniques) is approximately 70-80%.
Other options include sperm retrieval from the epididymis or the testis, followed by in vitro fertilization (IVF).

Reply Date: 2002/06/27

More Info

Yes, you can use testicular sperm retrieval (TSR) for IVF after a vasectomy. This method is a viable option for men who have undergone a vasectomy and wish to father children after the procedure.
When a man has a vasectomy, the surgical procedure cuts and seals the vas deferens, the tubes that carry sperm from the testicles to the urethra. This effectively prevents sperm from being included in the ejaculate, leading to infertility. However, many men who have had a vasectomy later decide they want to have children again, and there are several options available to them.

One option is vasectomy reversal, where a surgeon reconnects the vas deferens. However, the success rates for this procedure can vary, typically ranging from 70% to 80%, depending on various factors such as the time elapsed since the vasectomy and the surgical technique used. Additionally, even if the reversal is successful, it may take time for sperm production to normalize, and there is no guarantee of pregnancy.

On the other hand, testicular sperm retrieval is a more direct approach. This procedure involves extracting sperm directly from the testicles, which can then be used for in vitro fertilization (IVF). There are a couple of techniques for TSR, including:
1. Percutaneous Epididymal Sperm Aspiration (PESA): This method involves using a needle to extract sperm from the epididymis, the tube where sperm matures and is stored.

2. Testicular Sperm Extraction (TESE): In this procedure, a small incision is made in the testicle to retrieve sperm directly from the testicular tissue.

Both methods can be performed under local or general anesthesia, and they are generally considered safe with minimal complications. The retrieved sperm can then be used in conjunction with IVF, where the eggs are fertilized in a laboratory setting and subsequently implanted into the uterus.

It's important to note that while TSR is a highly effective method for obtaining sperm, the quality and quantity of sperm retrieved can vary. In some cases, sperm may not be present in sufficient numbers or may not be viable, which can affect the success of IVF. Therefore, it is crucial to consult with a fertility specialist who can evaluate your specific situation, discuss the potential outcomes, and help you make an informed decision.

In summary, if you are considering having children after a vasectomy, testicular sperm retrieval is a feasible and effective option for IVF. It allows you to bypass the need for a vasectomy reversal and can provide a direct source of sperm for fertilization. Be sure to discuss this option with your healthcare provider to understand the procedure, its implications, and the best approach for your circumstances.

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