It is possible for couples to conceive through artificial insemination (AI) after a vasectomy. Still, many doctors recommend a vasectomy reversal as it is often the most cost-effective and successful route to having a baby after a vasectomy.
There may be factors involved that would make artificial insemination the best option for having a baby after a vasectomy, such as the age of the woman and the time since the man’s vasectomy. However, artificial insemination after a vasectomy is only possible if the man has banked sperm or through a relatively new process known as intra-cytoplasmic sperm injection (ICSI).
Whatever your situation may be, you’ll need to seek the advice of a fertility professional to determine what’s right for you and your partner.
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Vasectomy reversal or artificial insemination?
Traditional artificial insemination methods like in vitro fertilization (IVF) are available if the man banked sperm before his vasectomy. If he didn’t do take this step, artificial insemination may be possible with the help of ICSI, which we discuss in the next section.
While artificial insemination may be a good option for couples who are experiencing severe fertility issues, most doctors agree that a vasectomy reversal is ultimately the better choice.
When a vasectomy reversal is done with a microsurgical approach by an experienced surgeon, the success rate is approximately 95% for return of sperm in the ejaculate and approximately a 65% pregnancy/delivery rate. These numbers can vary greatly depending on female fertility factors (mostly age) and the experience of the surgeon.
There are many metrics IVF centers use to evaluate success, but the most important factor is the take home baby rate. In the US, every major IVF center is part of the Society for Assisted Reproductive Technology (SART) and is required to report their outcomes. Overall, these centers report a 30-35% take home baby rate per cycle of IVF.
Considering that the cost of a single cycle of IVF is around $10,000 to $20,000 and the cost of a vasectomy reversal is between $3,000 and $10,000, vasectomy reversal is often the most cost-effective approach in this situation.
Reasons to choose artificial insemination
Even though doctors may steer couples towards the vasectomy reversal option, there are a handful of reasons why artificial insemination may be the better choice.
- Vasectomy reversals are not always successful, with failure rates ranging from 10% to 20%. While additional reversal operations may result in the restoration of a man’s fertility, the idea of multiple procedures may be unappealing to some men.
- Overall success rates of vasectomy reversals declines with time. According to one source, vasectomy reversals are most likely to succeed when performed three years after vasectomy and are only 30% successful when performed 10 years after.
- If a man only wants one additional child, he may wish to remain sterile after the child is conceived. Artificial insemination can allow a couple to have “just one more” without undoing the man’s vasectomy.
Post-vasectomy artificial insemination methods
There are two primary methods available to couples in which the man has had a vasectomy:
- Intrauterine insemination (IUI)
- In vitro fertilization (IVF) with intra-cytoplasmic sperm injection (ICSI), often written as IVF/ICSI
Intrauterine insemination (IUI)
Intrauterine insemination involves injecting a man’s sperm directly into his partner to produce a pregnancy.
IUI is only possible if a man banked sperm before his vasectomy. If banked sperm is available, then intrauterine insemination may be possible after a vasectomy. Otherwise IVF (in conjunction with ICSI) must be used.
In vitro fertilization involves directly fertilizing a woman’s egg outside of her body then placing it back into her uterus.
IVF was traditionally performed with sperm collected from sample provided by the man, but this is obviously not possible for a vasectomized man.
A technique known as ICSI (intra-cytoplasmic sperm injection) allows doctors to obtain viable sperm from a man even after a vasectomy. This sperm can then be used for IVF (invitro fertilization) to help a woman become pregnant.
The concept behind IVF/ICSI is fairly simple, although the process itself requires cutting edge technology and highly trained fertility professionals. In ICSI, sperm are extracted from the man’s testicle or epididymis through a process known as sperm aspiration (aspiration is simply the medical term for “removal”). Using a microscope, a single sperm is injected into the donor woman’s egg. This fertilized egg is then implanted into a woman’s uterus, which will often result in a pregnancy.
ICSI success rates
The Infertility Center of St. Louis Fertility Clinic, which helped pioneer ICSI, reports that an ICSI/IVF cycle results in a fertilized embryo 70% of the time and produces a pregnancy 50% of the time.
There are numerous factors that can affect the success rate of ICSI, including female fertility conditions and the experience of the clinic performing the procedure.
Some couples may wonder if sperm extracted via aspiration (as in ICSI) can be used for IUI. Sperm extracted from a man’s testicle or epididymis is not mature and is generally unable to penetrate and fertilize the wall of a woman’s egg. This is why it must be directly injected into a woman’s egg via IVF.