My husband had a vasectomy reversal about 12 months ago and we think he scarred, as his numbers went down to 2 sperm and no motility in his last sample:(. Due to our financial situation, we cannot afford to do IVF. However, my insurance covers IUI and I don't understand why they can't just extract sperm and give it a head start through IUI. He also has two sons and a dr we saw thought there is no reason why he shouldn't still have good working sperm to extract.
Hi, unfortunately, sperm that is extracted from the testicle do not work with IUI. Testicular sperm have not yet acquired the ability to swim and to fertilize an egg from the outside, both necessary functions of the sperm if they are placed in the uterus.
Sperm harvested from the epididymis may swim but the chances of pregnancy after placing them in the uterus are incredibly small. We know that from the days when the only option that was available for epididymal sperm was IUI and it was not a worthwhile technique. IVF changed all of that and then the addition of ICSI (putting a single sperm into an egg) improved success rates dramatically.
A redo reversal with an expert is also possible. Those of us who do reversals at a high level of expertise do perform redo surgery on patients as well as first-timers. Post-operative closure one time does not necessarily predict closure a second time. But of course, there is still that cost as well.
Hope this helps,
Dr. Robert Oates (Boston)
Published on Jul 11, 2012