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Vasectomy reversal or IVF?

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    Hi, I’d like to have a baby with my husband, but he’s had a vasectomy. The story is that we’ve both got kids from previous marriages, he’s 37 and I’m 31. He had the vasectomy about 7 years ago. I’ve been reading up on this, and know there are two ways we might be able to have a baby.

    Either he has a reversal, or we go down the route of sperm extraction and IVF. The thing is, we don’t have unlimited funds, and can only pick one of the options. My question is which of the two options is most likely to allow us to have a baby?

    Dr. Edward Karpman

    Numerous studies have been conducted looking at the costs of having children after a vasectomy. Our two options are vasectomy reversal and sperm retrieval with IVF/ICSI. Vasectomy reversal has consistently been shown to be the most cost-effective approach for having children after a vasectomy. Even when we look at certain situations such as a re-do vasectomy reversal, requiring the more complex epididymovasostomy or in the case of an older female partner, vasectomy reversal still remains more cost-effective.

    We know that the success rate of a vasectomy reversal is approximately 95% for return of sperm in the ejaculate with approximately a 65% pregnancy rate/delivery rate, when done with a microsurgical approach by an experienced surgeon.

    There are many numbers or outcomes IVF centers use to evaluate success such as fertilization rate, implantation rate and pregnancy rate. But the most important factor is the take home baby rate and this is easily evaluated. In the US, every major IVF center is part of the Society for Assisted Reproductive Technology (SART) and is required to report their outcomes. Most centers, across the board, report a 30-35% take home baby rate per cycle of IVF.

    Considering the costs of a single cycle of IVF is $15,000-$20,000 with a 30-35% success rate per cycle, and the cost of a vasectomy reversal is between $7,000 and $10,000, it is no surprise that vasectomy reversal is the most cost-effective approach in this situation.

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