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If you have any questions, you may call us at  (314) 576-1400

Comparing Microscopic Vasectomy Reversal vs. Sperm Retrieval and ICSI:
Dr. Silber’s conclusions


It is highly possible that you have heard of a technique called sperm retrieval and Intra-Cytoplasmic Sperm Injection (ICSI) which was developed by me and my Brussels’ colleagues in 1993. Since we are the team that invented this procedure, we naturally have the most extensive experience and success in performing it. This procedure involves direct aspiration of sperm from the husband’s testicles or epidydymis and the injection of a single sperm into the cytoplasm of each of the wife’s eggs, resulting in fertilization. This procedure requires surgery for the husband and a very stressful IVF procedure for the wife. Therefore we prefer to perform sperm retrieval and ICSI for patients who have congenital absence of the vas or for those in whom there is no possibility of surgical repair. For most vasectomy cases, it is still more cost-effective and easier for the wife to just do a competent vasectomy reversal on the husband.

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 to reconnect your ducts microsurgically. This involves no greater surgical discomfort than the sperm retrieval 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 retrieval and ICSI. However, 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, we have the capability to freeze and store sperm retrieved from your epididymis or vas. 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 if you decide you prefer that. But, nonetheless, a microscopic vasectomy reversal is actually your least painful and most successful option if it is performed properly. 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.

To get feedback from patients who have undergone treatment at our Center, click here to go to the Patient Comments page.

If you have any questions, you may call us at  (314) 576-1400