Men who have had a vasectomy still have options for having children. In some cases, a second surgery to reverse the vasectomy may restore male fertility. If a reversal is not possible or does not result in a normal sperm count, more high-tech medical treatments, surgical and non-surgical, offer options for having children.
Vasectomy Reversal
A vasectomy reversal involves a more complicated surgical procedure under general anesthesia to reconnect the tubes that were cut during vasectomy. According to the Mayo Clinic, approximately half of the vasectomy reversals performed are successful in that sperm can be found in the ejaculate within a few months of the surgery. The surgeon who performs the vasectomy reversal can recover some sperm from the testes or the sperm storage organ lying on top of the testes, called the epididymis, during the reversal surgery. This sperm specimen can be frozen and stored so that the patient has stored sperm to use for fertility treatments if the reversal should fail.
In Vitro Fertilization
In vitro fertilization (IVF) is a medical procedure in which sperm and egg are fertilized in the laboratory and the resulting embryos are transferred back to the uterus to create a pregnancy. According to the American Pregnancy Association, men who have had a vasectomy or other conditions resulting in no sperm or a very low sperm count, may benefit from IVF with intracytoplasmic sperm injection (ICSI) because relatively few sperm are needed for this procedure. ICSI is performed by a fertility lab technician who can carefully pick up and inject a single sperm into a single egg under the microscope, facilitating fertilization. Sperm counts after vasectomy reversal may be too low for pregnancy to be possible from intercourse or insemination, but may be plenty for IVF, especially if ICSI is used. If sperm was frozen during the patient's vasectomy reversal procedure, this sperm can often be used for IVF with ICSI.
Some patients may choose not to have a vasectomy reversal surgery first but instead go straight to IVF. In this case, a small quantity of sperm can be recovered from the testicles or epididymis during an outpatient surgical procedure under anesthesia. Sometimes, a needle can be used to aspirate sperm from the testes or epididymis using minimal local anesthesia. This surgically recovered sperm can be used to fertilize the partner's eggs.
Donor Sperm
The third option which avoids surgery altogether is to use donor sperm to fertilize your partner's sperm. Sperm can be brought from an anonymous donor through various commercial sperm banks. Sperm banks are required by the U.S. Food and Drug Administration to screen potential donors for various infectious diseases. Some sperm banks also provide additional medical, physical and social information about the donor so that clients can roughly match their own characteristics.
Using anonymous donor sperm means giving up the genetic link to a child but avoids the expense and risks associated with surgery. Donor sperm can be used for less expensive and invasive insemination procedures, bypassing the need for IVF.
