For couples who desire a pregnancy after a vasectomy procedure, an alternative to vasectomy reversal is sperm retrieval in conjunction with In Vitro Fertilization (IVF) with Intracytoplasmic Sperm Injection (ICSI).
This is an ideal choice for couples in whom there are significant female factor infertility issues such advanced maternal age or ovavian/tubal problems.
In such cases, IVF/ICSI may be required to get pregnant, and a simpler approach than microsurigcal vasectomy reversal is to remove some sperm from the epididymis or testis and use this for IVF/ICSI.
Sometimes a couple will request sperm retrieval to be performed with Intra-Uterine
Insemination (IUI), as this is not very invasive and appears to be the least costly
alternative for getting pregnant after a vasectomy. However, IUI can ONLY be
performed with fully mature sperm from the ejaculate, and the success is highly dependent on having adequate numbers of motile sperm present (>10 million).
Unfortunately, sperm retrieved from the epididymis and testicle are not mature enough or adequate in quantity to get pregnant with this form of assisted reproduction.
In fact, attempts at even performing conventional IVF with testicular or
epididymal sperm have been met with such poor success that most IVF centers today
will only perform the more sophisticated ICSI procedure in cases where epididymal or testicular sperm is present, as is always the case after a vasectomy.