MANday: Vasectomy Reversal vs Sperm Retrieval

Dr. Russel H. Williams, MD has been providing microsurgical vasectomy reversals for over 20 years. The microsurgical vasectomy reversal operation has championed the return of sperm back into the ejaculate with success as high as 90%.

Over the last 20 years, Dr. Williams has seen thousands of couples trying to select the best option for them to obtain a pregnancy after a vasectomy.  

The option of bypassing a vasectomy reversal and undergoing a sperm retrieval and in-vitro fertilization (IVF) resonates with some couples. This is especially true if there are any female factors complicating the future pregnancy or if a man wants to have one additional child and maintain his vasectomy.

Couples wanting to dive deep into the numbers comparing the two forms of treatment can refer to this article (copy and paste into Google search. Select the first article in results): Palermo et al. (2015). Reversal of vasectomy in the era of intracytoplasmic sperm injection (icsi) is not worth the effort. Urology.

Sperm retrieval, a microsurgical anesthesia-based procedure, is where a small window is made into the scrotal sack with extraction of high-quality sperm from the testicle.

A small surgical window is made to inspect the testicle and micro-surgical technique is used to minimize trauma on the testicles, to ensure a quick recovery, and to provide the highest quality of sperm for IVF.

The sperm is released from the testicle into very small tubes called the epididymis. The epididymis is the most desired location for a successful sperm retrieval. The epididymis should have a collection of both good and bad quality sperm. Sometimes, the epididymis does not provide good quality sperm and sperm needs to be extracted from the testicle. The microsurgical magnification will facilitate the surgeon to avoid bleeding and to select areas of good quality sperm.

Once the sperm is extracted, it is immediately sent for use with IVF or can be frozen for later use. An enriched media solution is used to provide the greatest protection for the sperm after retrieval. If freezing of the sperm, also known as cryopreservation, is done through us, then we will provide a detailed report of the quality of the sperm before freezing and after freezing. Frozen sperm can also be transported to another location or city as needed.

The recovery is usually two or three days of light to moderate activity with some low-dose pain medication. Over the last 20 years, Dr. Williams has seen the complication rate associated with a sperm retrieval to be less than one to two percent. The noted complications are a superficial skin infection at the incision site or a small blood accumulation below the skin.

Lastly, all men coming in for a discussion about fertility options after a vasectomy will have a full physical examination that includes hormone evaluation to determine if their fertility health is optimal. Sometimes, varicoceles or other conditions affecting testicular health are identified and addressed not only to enhance fertility, but also to maintain testosterone production. The best quality sperm leads to the highest IVF success rates. We take care of men’s health care needs through all life’s stages.

Russel H. Williams, MD

Dr. Russel H. Williams is the founder, CEO and CMO of The Y Factor and brings more than 20 years of experience. Dr. Williams earned his Medical Degree at the University of Texas at Dallas Southwestern Medical Center, where he graduated at the top of his class. He completed his urology residency at Baylor College of Medicine in Houston, then completed a male reproductive medicine and microsurgery visiting fellowship at the New York-Presbyterian/Weill Cornell Medical Center in Manhattan, New York. Dr. Williams is an active member of the American Urological Association, American Society for Reproductive Medicine, and peers recognize him as one of only a handful of Reproductive Urologists focusing on men’s urological wellness & fertility.

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