Five-hundred thousand men in the United States undergo vasectomy annually. Approximately 6% of these men will change their minds about their choice of having undergone surgical contraception. The two options facing couples who want to conceive when the male partner has previously undergone vasectomy are vasectomy reversal (VR) or sperm retrieval (SR) with in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). There are numerous factors that may impact a couples’ decision making on which route is most appropriate for that couple. In many instances, the male partner is only evaluated by a urologist and counseled and treated with a VR without an evaluation or counseling of the female partner, or the female partner is evaluated by a reproductive endocrinologist on the option of IVF/ICSI, and the male partner is referred to a urologist to perform SR for use with IVF/ICSI. At Austin Center for Vasectomy and Vasectomy Reversal, which is a division of Austin Fertility & Reproductive Medicine, all patients are offered both options, and then they may proceed with whichever option they feel is best for them after counseling.
For men presenting for VR, they are offered the opportunity to have their female partner evaluated by a reproductive endocrinologist within the practice to make sure as a couple they are a good candidate for the ability to conceive together via VR, and to be counseled on the option of SR/IVF for couples who find that to be a more fit option. The point is, both sides of the couple have the opportunity to be evaluated and counseled by the respective specialists. As we find couples care an important approach to patients when they are interested in it, and all options can be offered, we published a study in Andrology, evaluating what factors such as male age, female age, time since vasectomy and ovarian reserve status impacted couples’ decision making between the two options.
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