Reversing the Snip
Dr Jeffrey Persson | 20th Apr 2015
Is it too late to have another chance at fatherhood?
Life can be unexpected. Although having a vasectomy may have been right for you a few years ago, you may be wishing that it wasn’t so permanent, as you now want to have another child.
Is it too late to change your mind?
Every year more than 25,000 men have a vasectomy in Australia – but about 3% of these men later decide they do want to have another child after all1. Some are able to do this by reversing their vasectomy. Others use assisted reproductive technology such as IVF to conceive a child.
How long is too long to wait to reverse a vasectomy?
The length of time between the vasectomy and reversal can make a difference to how successful you might be in conceiving a baby naturally. After a vasectomy reversal, sperm usually returns progressively over time and by 3 months around 90% of men will have sperm present. However success depends on the degree and length of damage done to the vas deferens during the original operation as well as the time passed since the vasectomy - after 10 to 15 years the chances fall significantly. Even after a technically successful reversal surgery, pregnancy is not guaranteed.
What other factors affect the success of a vasectomy reversal?
When considering a vasectomy reversal, it’s worth remembering that we’re not just looking for sperm to be present, we’re looking to achieve a pregnancy, so we need to take into account the female partner and couple as a whole.
The age of the female partner is the single most important factor influencing the likelihood of a pregnancy after a vasectomy reversal. The female partner’s fertility such as egg reserve and existence of fertility issues such as endometriosis or PCOS should be taken in to account before proceeding with a reversal. Because assisted reproductive treatment (ART) may be a better option.
Success can also be affected by the presence of anti-sperm antibodies in the male. Sperm antibodies block the movement or function of the sperm which can decrease the chance of a successful pregnancy.
What is the alternative to vasectomy reversal?
Instead of going through a vasectomy reversal, many couples choose to undergo an IVF cycle using surgical sperm retrieval and intracytoplasmic sperm injection (ICSI).
Some Fertility Clinics are setup to check the quality of the sperm retrieved, at the same time as it is collected, to give couples greater peace of mind that they are in the best position to create an embryo from a future IVF or ICSI cycle.
Another advantage of choosing the IVF route, over a reversal, is that it leaves the contraception intact. If you only want one child, this may be the better option.
How does ICSI work?
Even though you’ve had a vasectomy, you’re still producing sperm. These sperm are surgically retrieved from the epididymis, at the back of the testis.
ICSI is part of a standard IVF treatment cycle, however, unlike conventional IVF where the sperm and egg are left to fertilise in a petri dish, during ICSI a single sperm is injected into each egg, under a microscope. This increases the likelihood of fertilisation with the limited sperm that has been retrieved.
Vasectomy reversal, or IVF and ICSI?
In summary, there are a few things to consider if you’re trying to decide between vasectomy reversal or IVF and ICSI.
- How long has it been since the vasectomy? This will affect your chances of conceiving naturally after a reversal.
- What are the total financial costs for both options? A vasectomy reversal is covered by health funds and conception could occur naturally if there are no other fertility issues. IVF with ICSI is partly covered by Medicare.
- How many children are you planning? This will help you evaluate the total cost (for example, if you’re only after one child, IVF may be more cost effective). Additionally, IVF might also be the better option if maintaining the vasectomy as a form of contraception is important longer term.
- Are there any female fertility issues? Assessment of the female partner’s reproductive health is important as any identified issues will influence the prospect of achieving a pregnancy naturally after a reversal.
It’s important to discuss all these points, along with your specific situation and medical history, with a fertility specialist. A fertility specialist can assess both partners and give you advice on which option will give you the best chance of a successful pregnancy.
To find out more, speak with an expert: