Which Option is Right for You?
Vasectomy is a form of birth control for men that is meant to be permanent. During vasectomy, the tubes that carry sperm are closed or blocked. Vasectomy is nearly 100 percent effective at preventing pregnancy. But what if your partner has had a vasectomy, and now you want to have children?
There are two ways to restore a man’s fertility after a vasectomy. One is vasectomy reversal. The other is to withdraw sperm from the testicle, inject it into an egg in the lab, and fertilize the egg, a procedure called sperm aspiration with ICSI and IVF. Let’s look at each of these procedures.
In order to reverse a vasectomy, the tubes that were blocked or tied have to be rejoined again. How they are joined depends on what the surgeon finds when he or she checks for sperm within the tubes, known as the vas. If sperm are present in the vas, then the tubes can be joined together, and the vasectomy is likely to be successful. If there aren’t any sperm, that means there is probably a blockage closer to the testicle. This is a more complicated surgery and is less likely to be successful. However, a lot depends on the experience of the surgeon who is performing the reversal.
Vasectomies can be reversed even after long periods of time. However, a vasectomy reversal doesn’t guarantee that a man’s female partner will be able to conceive naturally. The length of time since the vasectomy, her age and fertility status, and the surgeon’s experience all affect the success of the reversal and achieving pregnancy. Vasectomy reversal is delicate microsurgery which takes three to four hours to perform. If you’re considering vasectomy reversal, it’s best to go to a surgeon who has performed many of these procedures.
The cost of vasectomy reversal varies depending on what part of the country you are in, and ranges from $2,000 to $12,000, according to the University of Iowa Department of Urology. Insurance coverage for vasectomy reversal varies widely throughout the country and among insurance companies. If the female partner is younger and doesn’t have fertility problems, vasectomy reversal may be a good solution to help you have a family. If the female partner is over 35, fertility specialists recommend evaluating her fertility before proceeding with vasectomy reversal. If you will need IVF to become pregnant, there’s no need to reverse the vasectomy.
Be sure to check with your insurance company about how vasectomy reversal will affect your coverage for infertility. Many insurances require a “successful” reversal before they will cover infertility treatment. “Successful” may be defined differently by different health plans, and some will deny coverage if infertility is caused by or related to the vasectomy, whether it has been reversed or not.
IVF with Sperm Aspiration and ICSI
If you are female and over 35, or if you are younger and have had fertility problems, it’s appropriate to be evaluated by a reproductive endocrinologist. This fertility specialist will measure your ovarian reserve, which is the quality and quantity of your eggs, and look for other factors which may affect your fertility. If your physician recommends IVF, then the male partner’s sperm can be extracted from his testicle, a procedure called sperm aspiration, and injected into your eggs in the embryology lab. This is called ICSI, intracytoplasmic sperm injection.
ICSI is used sometimes when a man has not had a vasectomy but his sperm quantity or quality is low. After a vasectomy, sperm aspiration and ICSI avoid any issues with the vas being blocked. If your fertility specialist recommends IVF, your partner won’t have to go through the expense and recovery from surgery that are part of vasectomy reversal.
The cost of IVF with ICSI and sperm aspiration also varies depending on where you live and how many fertility specialists are in your area. The American Society for Reproductive Medicine (ASRM) estimates the average cost of an IVF cycle in the USA to be $12,400, which does not include the cost of fertility medications. These medications can cost from $4,000 to $10,000 per cycle. ICSI costs about $1,500, and the cost of sperm aspiration ranges from $3,000 to $12,000, depending on the difficulty of the procedure and what part of the country you live in. Insurance coverage for fertility treatment varies widely from one state to another.