Is there a way to extract semen without reversing a vasectomy?

The options for you include not only aspiration and IVF (extraction of sperm) but a reversal as well (with or without aspiration and freezing at the same time in case the reversal is not successful). One of the limitations to aspiration and IVF is that if you are not pregnant within that cycle, you have no chance the next month or the next month or the next month until you do another IVF cycle. The real conversation should always be about what maximizes your chances for pregnancy - with a reversal that is successful, you have a chance through natural means each and every single month - if you want to supplement that with an IVF cycle, that would be just fine. So, when couples select aspiration and IVF, they are limiting their options to just IVF. A good option for some, but it might not be the best option for most.

Hope this helps, Dr. Robert Oates
robertoatesmd.com

Published on Jul 11, 2012

Sperm extraction is very expensive and does not result in enough sperm for intrauterine insemination. The sperm extracted can be used for IVF (in vitro fertilization) but that usually costs over $10,000 per attempt.

Published on Jul 11, 2012

Sperm can be extracted from the testicles with a procedure called a TESA. It is not inexpensive and will also require IVF which is even more expensive. A vasectomy reversal is often done under general anesthesia.

Published on Jul 11, 2012

There are four options to achieve a pregnancy following a vasectomy. Adoption, donor sperm insemination, sperm retrieval and in vitro fertilization or microsurgical vasectomy reversal. Microsurgical vasectomy reversal is the only way to conceive naturally following a vasectomy, and the procedure is performed while the patient is asleep under anesthesia, unlike a vasectomy that is usually performed with the patient being awake. A reversal is highly successful when performed by a fellowship-trained microsurgeon, with success rates as high as 90 percent, allowing for unlimited pregnancy attempts. The total cost of a microsurgical vasectomy reversal is typically $10,000-$12,000 if it is not covered by insurance, and this fee includes facility, anesthesia and surgeons fee.
A sperm retrieval procedure to surgically extract sperm following a vasectomy is often performed under sedation and local anesthesia and can involve needle aspiration into the epididymis - called a PESA - percutaneous epididymal sperm aspiration or an open extraction into the testicle - called a TESE - testicular sperm extraction. Although you are correct in that sperm retrieval is less expensive than a vasectomy reversal, the speed extracted can only be used in conjunction with in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) and the reproductive technology is not typically covered by insurance post-vasectomy. It can be very expensive, up to $15,000-$20,000 a try.

It is important to consider all factors when deciding on what option is best for post-vasectomy pregnancy. Advanced age of the female partner, insurance coverage for IVF/ICSI post vasectomy, or the desire to only have one child may sway one's decision toward sperm retrieval and IVF. With all treatments being out of pocket, one may strongly consider vasectomy reversal for financial considerations, as well as for the desire to restore fertility back to baseline, the desire to have unlimited attempts at pregnancy, especially if more than one child is desire, or if getting pregnant naturally is important.
Dr. Karen E. Boyle
Chesapeake Urology Associates

Published on Jul 11, 2012