Vasectomy and IVF


#1

My husband had a vasectomy during his last marriage. We now want a child desperatly. Our Fertility clinic recommended IVF with ICSI…Basically they surgically extract his sperm and include it in the regular IVF treatment…Does this make sense? Has anyone had any experience with this? Please help, there is too much information over load!!!


#2

That was the approach that our RE recommended too. My DH had a vasectomy at age 26 after his second child during his first marriage. Our marriage is both our second marriage and early in the marriage we decided to try to have children. My DH had TWO reversals done. Each reversal had complications! We were not willing to have him go through more surgery or trauma to his male parts since he suffered so much from his prior surgeries. We then resorted to donor sperm with IVF. The IVF worked on our first try and we are now 31 weeks preggo. Good Luck with everything. Feel free to pm me if you have any questions… :flower:


#3

I’m new to this whole infertility business too and trying to figure things out. There is a lot of information on the internet and a lot of it conflicts in one way or another.

One thing that I see repeated in multiple places: Vasovasostomy and/or vasoepididymostomy are more cost effective and less stressful on the woman than TESE and IVF. Based on what I’ve heard of IVF it does sound like a plumbing fix is a much better route to go if it’s possible.
([FONT=Times New Roman][SIZE=3][/SIZE][/FONT][FONT=Times New Roman][SIZE=3]http://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Practice_Guidelines/Educational_Bulletins/The_management_of_infertility(1).pdf)

Many sources on the internet state that the time between vasectomy and attempted reversal influences the chances of success. Some sources claim that if done correctly time isn’t a huge issue.

“[/SIZE][/FONT]Contrary to general myth, the duration of time since vasectomy does not significantly affect the success rate.”
(Vasectomy Reversal explained by World-Leading Vasectomy Reversal Specialist Dr. Sherman Silber of the Infertility Center of St. Louis)

“[B]Dr. Werthman has helped a man father a child 57 years after his vasectomy, the oldest on record.”
([/B]Common Myths & Misconceptions | Center for Male Reproductive Medicine and Vasectomy Reversal)

“If the time interval is greater than 15 years, the success rate is about 75%.”
(Vasectomy Reversal Facts)

Which of these sites has the most up to date information? Who is realistic versus selling false hope? Are hospitals hasty to jump to the TESE/IVF solution because it’s in their financial interests to do so? I’m still trying to sort through the information.

I haven’t had a vasectomy but I’m dealing with azoospermia and trying to learn what I can. Insurance doesn’t typically cover a lot of this stuff, and it isn’t cheap. It can’t hurt to call around and get all the information you can so you can make an informed decision that will be the best for your health and bank account. I know that a lot of people in this forum jump to the TESE/IVF solution really quickly as if it’s the only real option. I have no idea if that’s an indication of how things work in the real world or if advances in medical technology are bringing new hope for chances of natural conception.

Good luck and keep us informed about what you learn.


#4

Hello, and congratulations!!

My Dr. does not recommend Reverse Vasectomy because it is invasive and has a low success rate. So he is recommending a procedure called ICSI. I cant remember what it stands for, but they surgically remove sperm from my husband. Apparantly there is still viable sperm stored in his anatomy. "Sperm can be aspirated with a needle from the testicle or from the vas deferens (a structure right next to the testicle that also contains sperm). "

I think its a fairly new procedure, so i cant find much info about it.


#5

My husband had a vasectomy about 13 years ago - we did a reversal about 2 years ago but there was a lot of scar tissue and they were only able to reconnect one side. It did not work although they saw viable sperm before they reconnected.

So, my poor man went through the testicular biopsy to get the sperm for IVF. He’s a tough guy, but it was very painful. They retrieved 4 vials - just keep in mind that every time you go through an IVF cycle they will use up one vial.

However, maybe we are lucky now, we’ve been through 2 cycles and I have my BFP with my first beta yesterday. :slight_smile:

My advice, don’t put him through the reversal - not worth it. It is not super likely to work and he will be in pain either way.

Let me know if you have any other questions about the biopsy.


#6

I was in the same situation. My DH had a vasectomy about 10 years ago after his second child, his first marriage. When we got married we knew we wanted a child together. We met with a urologist to discuss a reversal. He recommended we went straight to IVF because a reversal after 10 years does not have great success rates. Even if the reversal was successful, he said it could take years for us to get pregnant.
We met with a fertility specialist and decided to move forward with IVF. They had to do a testicular biopsy to get the sperm from my husband. Then we proceded with IVF w/ICSI. ICSI is actually where they inject each egg with a sperm instead of letting them fertilize on their own.
If you have any questions feel free to ask or PM me.
As you can see it worked for us, we are currently 30 weeks pregnant with twins!

[quote=Lal7373]Hello, and congratulations!!

My Dr. does not recommend Reverse Vasectomy because it is invasive and has a low success rate. So he is recommending a procedure called ICSI. I cant remember what it stands for, but they surgically remove sperm from my husband. Apparantly there is still viable sperm stored in his anatomy. "Sperm can be aspirated with a needle from the testicle or from the vas deferens (a structure right next to the testicle that also contains sperm). "

I think its a fairly new procedure, so i cant find much info about it.[/quote]


#7

Like others, my husband had a child in a previous marriage, then had a vasectomy. We planned on adopting (I’ve always wanted to). When the time came, I found our jobs offered no adoption assitance, but did offer IVF benefits.

We talked and agreed to give IVF a try. I’m at CCRM with Dr. G. He immediatly asked if we were interested in a reversal, but we said no. He was happy as he says they have a low success rate. Apparently sperm have to learn how to swim, so even if there is not blockage (which often happens), moblity is another issue.

He explained how they do IVF/ICSI with TESA(the sperm apiration). However, the urologist has given us the warning that the TESA could turn into TESE(more invasive sperm removal) if there is low sperm count.

From what we’ve been explained/read, the procedure is pretty simple. DH will be sore for a day or two, but no worse than the orginal vasectomy.

Yes, it cost more. But for me, it is comforting. I hate to gamble and I feel like that is what this IVF thing is. However, the doctors feel confident that with the apiration, we will get sperm. So that is one hurdle to not worry about. The ICSI takes care of worry about if the sperm can penetrate the zona pellucida, something else to not worry about. So now all I have to worry about is producing enough good eggs, them fertilizing, them implanting, and carrying out the whole deal for 9 months :wink:

In some ways I feel like a fake to claim infertility, as the only known issue was not naturally occuring. Yet, it is nerve racking and heartbreaking all the same.


#8

Sperm issues

Has anyone gotten concern from Dr. about sperm quality/quanity before doing sperm retrieval. We were planning retrival with ICSI and urologist told DH might have to do TESE instead of PESA. Okay, no biggie. But then IVF Dr call today and said after talking to urologist, he want to talk about donor sperm. I don’t know if this is just to cover bases or if there is a real issue (we have appointments with both on Thursday).

Freaked out (of course) because DH doen’t want to use Donor and I am on the fence about it. We were told before that with ICSI they don’t need as many. It would suck if they got in him and didn’t find enough, but also suck to go this far and not use all our options.


#9

We did IVF/ICSI in November. They retrieved 8 viles of sperm from my husband who is 47 and had Vasectomy 20 years ago. Unfortunately, i was only able to produce 3 eggs and only 1 embryo survived which is now frozen.

When we started all this, it was because my husband had a vasectomy. Now it turns out, im the one with the low ovarian reserve : (

Will try again my next cycle in February.


#10

[quote=Lal7373]We did IVF/ICSI in November. They retrieved 8 viles of sperm from my husband who is 47 and had Vasectomy 20 years ago. Unfortunately, i was only able to produce 3 eggs and only 1 embryo survived which is now frozen.

When we started all this, it was because my husband had a vasectomy. Now it turns out, im the one with the low ovarian reserve : (

Will try again my next cycle in February.[/quote]

If you don’t mind me asking, what method of retrieval did they use for your husband, and did he have any complications? We’re in the same boat, and am getting mixed messages between the Urology center and our RE. Its aggrivating, to say in the least!


#11

I just wanted to update. After talking to Dr. DH’s hormones are low. Another concern is atrophy in testicals. (one testical sig. smaller than other and vasectomy can’t be felt in larger one, implying it also experiencing atrophy)

They were saying we had a good chance of having to have a mPESE (microdisection) if we wanted to continue with our IVF/ICSI. However, we feel the odds are not in our favor and it not worth slicing DH’s testes open. We’ve decided to proceed with DS. So now we are on the IUIw/ clomid and DS.


#12

ivf isci

my hubby and i have done ivf/icsi. as a result we have 2 beautiful daughters from 2 different cycles. we are preparing to do a 3rd and final cycle. we know we are blessed beyond belief with 2 healthy children but i know in my heart i would regret not trying one more time. i am 38 and my dh is 40. to prepare for this cycle i have eliminated sugar, caffiene and changed my diet. which was not hard since i eat quite healthy to begin with. whole grains, no preservatives, all natural, lots of fruits and vegetables, no hormone added protiens. I also take supplements that i had read would help produce good quality eggs. Maca, Selenium, Royal Jelly, Wheat grass. As well as vitamins, prenatals, fish oil, Co q10, baby aspirin, and calcuim. I also ordered my dh ferilaid which i have not gotten yet. it is said to improve sperm quality…not necessarily quantity. which in icsi they don’t need many just good quality sperm. they do the actual fertilization for you by injecting the egg. We also plan on doing PGD (?) Not to determine gender, because I wouldn’t want to know but to rule out any genetic defects. I worry because of my advanced age even though at 38 not only do I look 25 I feel better than I dd when I was 18. Your situation is certainly not hopeless. You have options and I wish you best of luck!


#13

forgot to mention, our issue is male factor infertility. I am fine. But if I can get myself in A+ shape then that will certainly help. Also check into accupuncture. It greatly increases your success when it is male factor related.