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Vasectomy Problems

Vasectomy is the medical procedure that is used for the sterilization of a man and is a form of permanent birth control. The surgical procedure involves cutting the vasa deferentia and sealing each end to prevent sperm from leaving the body via seminal excretion (ejaculation). This procedure can usually be done in a doctor's office under local anesthetic and generally takes less than an hour to perform. To learn more about a vasectomy procedure, take a look below at the questions that have been answered by the Experts.

What are the ways to remove sperm to fertilize an egg without vasectomy reversal?

There are several procedures in which a man's sperm can be removed to enable pregnancy and it would be advisable to make an appointment with an urologist for a consultation on this. These include: Percutaneous Sperm Aspiration (PESA), Vasal Aspiration, Micro-epididymal Sperm Aspiration and Testicular Sperm Extraction (TESE): Percutaneous Sperm Aspiration (PESA): This is a non-surgical procedure which can be done with local anesthetic and takes only about 20 minutes. Generally, this procedure is used when sperm isn't present for retrieval due to the congenital absence of vas deferens or the growth of scar tissue. During this process, a needle is inserted into the scrotum through the epididymis and liquid is drawn. 10-20 million sperm are usually collected which means several retrievals are required in one or both testicles. When sperm is collected from the epididymis, ICSI (Intracytoplasmic Sperm Injection) is used to fertilize the egg to aid pregnancy since the sperm isn’t mature as yet. Vasal Aspiration: This procedure is usually used when the patient has either had a vasectomy within the last 5 years or when a blockage in the vas deferens prevents normal retrieval. This procedure is the only one which can retrieve mature sperm. Local anesthetic is used and a needle is inserted into the vas deferens. A massage is then done to produce more liquid. Once retrieved, the sperm is readied for IVF (In Vitro Fertilization). Since the sperm is mature, the possibility of preserving some of it with cryogenics to use in the future is also an option. Micro-epididymal Sperm Aspiration: This procedure is similar to PESA and performed while the patient is under a general anesthetic. A small cut is made via the scrotum into the epididymis where fluid is collected and then tested for viable sperm. Testicular Sperm Extraction (TESE): This procedure is generally done when the patient has a blockage in the epididymis near the testicles or when the sperm count is too low. The sperm is immature when retrieved and is taken from the testicles by way of a testicular biopsy. The procedure requires a local anesthetic and uses a needle to retrieve the sperm which is then taken to fertilize the egg through ICSI.

What are the success rates for having a child after a reverse vasectomy and tubal ligation?

Generally there is a 70-80% success rate for those under 40 years of age and those who attempt to conceive after these procedures usually succeed within a year after the procedure. The success rate increases to a 90% chance of getting pregnant within a year if the tubal was performed by microsurgery. With regard to vasectomy reversal, the time that has passed since the vasectomy was performed will typically determine the success rate of getting pregnant after a reversal. In many cases, a couple becomes pregnant only months after a vasectomy reversal. Usually there is a 52% success rate for vasectomy reversals within two years although the average is a year.

Is IUI with sperm the best chance of getting pregnant after a spouse has had a vasectomy?

Generally there are three options available for a situation such as this: vasectomy reversal, In Vitro Fertilization with Intracytoplasmic Sperm Injection (IVF/ICSI), and IUI using a donor's sperm. There is an alternative to a vasectomy reversal which is Testicular and/or Epididymal Sperm Aspiration. If this procedure is performed, the sperm will have to be used for In Vitro Fertilization with Intracytoplasmic Sperm Injection only. In this process, the egg is fertilized with the sperm being directly injected into it. IUI or Intrauterine Insemination may not work here since the sperm that is retrieved is usually not mature enough to fertilize the egg on its own. Vasectomy procedures are performed daily in the United States and around the world. Many of these procedures are done to prevent possible pregnancies while others are performed due to medical issues. If you are considering a vasectomy and have questions and concerns about it, ask an Expert now. They can offer medical information and suggestions based on the details of your case.
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