TESE after PESA with no live sperms success rates?

What is the possibility to go through TESE to find good sperms enough to be used for IVF from the person who had vasectomy about 20 years ago?
He went through PESA but the doctors did not find any live sperms.
For the background information, he was a heavy smoker for 20 years. ( 2 packs a day for 20 years) He still smokes about a pack a day. I am sure that smoking causes a lot of health issues including the quality of his sperms. Other than that he is healthy for now.

ANSWERS FROM DOCTORS (1)


Answered by John C. McHugh, MD

The overall health and the number of years since the vasectomy does influence the chances of recovering suitable sperm, however most would agree it is worth the attempt. Most of what I read in terms of percentages was based on non obstructive infertility, i.e. not having had a vasectomy. You can look at studies vasectomy reversals after twenty years and this does give some insight. One study in particular showed a 79% chance of seeing sperm in the ejaculate of males having had a vasectomy greater than twenty years before the reversal. So yes it is possible to retrieve viable sperm in your scenario and historically TESE has a higher success rate than TESA but in my cursory review I did not see specific percentages.

Published on Apr 12, 2017

Answered by John C. McHugh, MD (View Profile)

The overall health and the number of years since the vasectomy does influence the chances of recovering suitable sperm, however most would agree it is worth the attempt. Most of what I read in terms of percentages was based on non obstructive infertility, i.e. not having had a vasectomy. You can look at studies vasectomy reversals after twenty years and this does give some insight. One study in particular showed a 79% chance of seeing sperm in the ejaculate of males having had a vasectomy greater than twenty years before the reversal. So yes it is possible to retrieve viable sperm in your scenario and historically TESE has a higher success rate than TESA but in my cursory review I did not see specific percentages.

Published on Jul 11, 2012


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