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It is highly possible that you have heard of a new technique called Intra-Cytoplasmic Sperm Injection (ICSI) which was developed by me and my Brussels' colleagues, Dr. Andre Van Steirteghem and Dr. Paul Devroey. Since we are the team that invented this procedure, we naturally have the most extensive experience and success in performing it. The ICSI procedure involves direct aspiration of sperm from the husband combined with the injection of a single, weak or non-moving sperm into the cytoplasm of the wife's egg, resulting in fertilization. This procedure requires surgery for both the husband and the wife. We routinely perform sperm aspiration and ICSI for patients who have congenital absence of the vas or for those in whom there is no possibility of surgical repair.

For anyone who has had a vasectomy, or even one or more previous failed vasectomy reversals, the simplest, most cost-effective approach, as well as the best chance for a pregnancy would still be for me to reconnect your ducts microsurgically. This involves no greater surgical discomfort than the sperm aspiration and gives a 95% chance for a successful return of fertility, as compared to a 40% pregnancy and delivery rate per treatment cycle with sperm aspiration and ICSI. However, by having the ICSI option available as backup, you have virtually a 100% chance of success so long as the wife is fertile. Therefore, we do make sure to offer you the benefit of both vasectomy reversal and ICSI. This is how we do it.

At the time of your vasectomy reversal, our program has the capability to freeze and store sperm retrieved from your epididymis or vas. We do not enter your testicle for this, and so there is very little discomfort. This frozen sperm can be used as a backup if your wife is unable to achieve a pregnancy with your ejaculated sperm following your reversal, (which occurs in a small percentage of cases). By freezing your sperm at the time of your surgery, we will still have the opportunity of doing the ICSI procedure for your wife in the future, if necessary, without your ever having to go through another surgical procedure. We were the original developers of the ICSI procedure, and we can, therefore, provide you with the best possible results with sperm retrieval and ICSI. But, nonetheless, a microscopic vasectomy reversal is actually your least painful and most successful option.

Another alternative you may have recently heard about is "needle aspiration" in combination with an IVF/ICSI procedure. Needle aspiration is generally offered by doctors or clinics that do not have access to an operating room or delicate microsurgery. The only option these doctors can offer you is to stick a needle into your testicle. However, this type of aspiration, though easy for the doctor to perform, can result in testicular damage and a great deal of swelling and pain. Then your wife has to go through an involved and costly IVF/ICSI procedure requiring three or four months of injections, many trips to the clinic, and a huge drain on both her time and yours. This is a difficult procedure for her, is more costly than vasectomy reversal, and only gives a 40% pregnancy rate per each treatment attempt. Microsurgery for vasectomy reversal, properly performed, results in minimal pain and gives a 95% success rate. Therefore, microsurgical vasectomy reversal is still the simplest, most cost-effective first choice option for fulfilling your desire to have children.

Continue with: Microscopic Vasectomy Reversal (MVR)