Getting Pregnant After a Vasectomy
Which is Better: Vasectomy Reversal or In-vitro Fertilization?
Feb 25, 2009
Couples who wish to have a baby after a vasectomy procedure will likely face the choice of two fertility procedures: vasectomy reversal or in-vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). Vasectomy reversals generally have higher success rates than IVF with ICSI, carry fewer risks and cost less. For couples with no known obstacle to pregnancy other than the man’s vasectomy, the vasovasostomy vasectomy reversal procedure may help couples conceive a baby within a year.
Vasectomy Reversal Has a Higher Pregnancy Success Rate than IVF
The success rates for microsurgical vasectomy reversal dwarf in-vitro fertilization success rates, especially if the vasectomy was performed recently. For reversals done less than three years after the vasectomy procedure, the pregnancy rate is 76%. For those done four to eight years post-vasectomy, the rate hovers around 53%. (“Vasectomy Reversal Surgical Success Rates”, Reverse-vasectomy.info, 2009)
That said, the type of reversal procedure has an enormous impact on the success rate. The vasoepididymostomy reversal procedure or macrosurgical vasectomy reversals do not have as impressive success rates.
The CDC’s most recently reported pregnancy rates for IVF using ICSI are 32%. (“Assisted Reproductive Technology Report”, Center for Disease Control, 2006)
Vasectomy Reversal is Safer than IVF
Both vasectomy reversal and IVF with ICSI are relatively safe procedures with few complications. The difference in risk between the two procedures occurs after successful conception. Pregnancies that occur as a result of vasectomy reversal are no more risky than any other naturally occurring pregnancy, with no additional risk of multiples, birth defects or danger to the mother.
IVF, on the other hand, carries a higher risk of miscarriage, ectopic pregnancy, preterm birth, stillbirth, perinatal death and Caesarian section. That said, most of these risks are associated with multiple births common to IVF procedures and can be generally avoided by having only one embryo implanted.
Vasectomy Reversal Costs Less than IVF with ICSI
According to a Johns Hopkins Medicine report comparing the costs associated with vasectomy reversal and IVF with ICSI, two studies on the subject concluded that vasectomy reversal is much more cost effective. The cost of the procedures were similar (vasectomy reversals cost $6,800-$13,000 and IVF with ICSI cost $12,100-$15,400); however, the obstetric costs associated with vasectomy reversal were $15,000-$40,000 less than those associated with IVF. (“Vasectomy Reversal,” Johns Hopkins Medicine, 2008). Again, this is likely due to increased multiple births.
Vasectomy reversal is generally a less expensive, safer and more effective option for most couples hoping to have a baby after a vasectomy. If the woman has other specific fertility issues, perhaps IVF with ICSI is a better option. It should also be known that during vasectomy reversal surgery, many surgeons will harvest sperm to be frozen in case the procedure is not successful. Second reversal attempts do have high success rates, but should the couple still fail to become pregnant, the previously harvested sperm can be used for IVF using ICSI. A fertility specialist can help couples choose the best option for their specific medical situations.
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