Approximately half a million men in the United States undergo vasectomy annually. An estimated 6% of these men will change their minds about their choice of having undergone vasectomy and seek options to reestablish fertility potential. The two options available are vasectomy reversal (VR) or sperm retrieval (SR) with in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Many factors may impact a couples’ decision making on which route is most fit for that couple. In many cases, 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 Fertility & Reproductive Medicine/Westlake IVF, all patients are offered both options, and then they may select the option they feel is most appropriate for them after counseling.
All men presenting for VR are offered the option to have their female partner evaluated by a reproductive endocrinologist within the practice to make sure that 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 appealing option. The philosophy is that 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.