Moving Forward with Fertility after Vasectomy
The decision to reverse a vasectomy may come about after life changes, or a change of heart. Dr. Mark Rispler reassures male patients that many options exist to fulfill their desire to conceive a child after having a vasectomy.
During a vasectomy, a surgeon severs then seals the two vas deferens tubes that carry sperm from the testicles to the seminal fluid (semen) ejaculated during intercourse. The female equivalent of vasectomy is tubal ligation, which prevents an ovulated egg from traveling to the fallopian tube to meet the sperm.
Fertility after Vasectomy: Surgical Treatment
Successful vasectomy reversal — reconnecting of the vas deferens (tubes) — is possible in the great majority of cases. Known as vasovasostomy, the procedure leads to pregnancy rates of greater than 40-90 percent. This is because the testes never ceased to produce sperm; only the delivery method was affected by vasectomy.
When the tubes cannot be reconnected, surgeons may need to connect the vas deferens directly to the epididymis* in a procedure called vasoepididymostomy.
Complications that hinder or prevent conception after a vasectomy reversal include:
- More than 10 years has elapsed since the surgery.
- The vasectomy occurred during hernia repair.
- Significant damage to the vas deferens occurred during the procedure.
- Antibodies formed that attack a man’s own sperm.
- Additional blockages have occurred between the vas deferens tubes and epididymis (*the organ that stores sperm).
- Problems reconnecting the vas deferens occurred.
- No sperm were present in the testicles to cryopreserve (freeze).
Fertility after Vasectomy: Non-Surgical Treatment
Dr. Mark Rispler provides options to restore fertility in men who have had a vasectomy, as well as targeted treatment for men whose vasectomy reversal was not successful.
Conceiving a baby after vasectomy or vasectomy reversal may require one of the following sperm retrieval procedures:
What are Sperm Antibodies?
Antibodies, proteins that make up the body’s immune system, sometimes incorrectly assess sperm created after vasectomy or vasectomy reversal as ‘foreign’ and attack and destroy it. The Innovative Fertility Center lab combats this problem by mixing sperm with a protein solution that attracts and binds to the antibodies, leaving only the ‘clean’ sperm for use in an IVF cycle.
Microsurgical Epididymal Sperm Aspiration (MESA) collects mature sperm directly from blocked areas of the epididymis tube. This microsurgery requires an incision and general anesthesia.
Testicular Sperm Aspiration (TESA) employs needle aspiration to retrieve sperm directly from a sliver of tissues removed from the testicle. Immature sperm retrieved during TESA must be used in conjunction with ICSI.
Percutaneous Epididymal Sperm Extraction (PESE) is similar to TESA, but involves needle aspiration of sperm from the epididymis tube, not the testicle.
Dr. Rispler partners with urologists in the Los Angeles and Manhattan Beach area that expertly retrieve sperm during MESA, TESA and PESE for use in fertility procedures. Innovative Fertility Center and provides urologist referrals upon request.
Once sperm is collected from the testicles or epididymis, where sperm is stored, or retrieved from the cryobank, Innovative Fertility Center schedules a cycle of in-vitro fertilization with Dr. Rispler to retrieve oocytes (eggs) from the female partner.
IVF is explained in detail on the Innovative Fertility Center website, but essentially involves the use of fertility medications to stimulate a woman’s ovaries so she develops multiple eggs during a cycle. Eggs are retrieved, combined with sperm in the IVF lab, and resulting embryos are transferred back to the uterus.
After egg retrieval, the Innovative Fertility Center IVF lab embryologists will perform intracytoplasmic sperm injection (ICSI), when warranted, to fertilize the egg.
Who is a Candidate for Male Fertility Treatment after Vasectomy?
Almost any man that has had a vasectomy can become a father with the help of assisted reproductive technologies.
- Any type of vasectomy
- Any length of time since vasectomy
- Any age of the male partner
- Any man presenting with sperm antibodies
The two most significant factors to successfully conceiving after vasectomy will involve:
1. The age and fertility of the female partner: Men continue to produce sperm throughout their lifetimes, but women experience a significant decline in reproductive health in their mid to late 30s.
2. The presence of sperm in the testicles: With ICSI, it only takes a single sperm to achieve a successful pregnancy.
The IVF success rates associated with sperm aspiration with ICSI are around 50 percent when the female partner is younger than 37, and no other significant health problems exist.
Working with a fertility specialist in formulating a plan after vasectomy ensures that you have access to the latest advances in reproductive medicine. Deciding to become a parent is one of life’s greatest joys. Dr. Rispler will help you overcome obstacles to getting pregnant with the leading edge fertility treatments that help you reach your goal.
Contact the Manhattan Beach fertility center for a consultation with Dr. Rispler to discuss fertility after vasectomy.