Sperm Banking at the Time of the Vasectomy Reversal in 2023
This article is written by vas reversal author and authority Dr. Sheldon Marks to explain the role, benefits and limitations of sperm banking at the time of a vasectomy reversal.
Here at ICVR, we offer sperm banking, also called sperm cryopreservation, at no additional charge to all of our patients at the time of the vasectomy reversal. The thought is that if there should be rare problems or scarring of the connections in the future, it would be nice to have sperm frozen, “just in case”. Having cryopreserved sperm can save couples many thousands of dollars and prevent the need for more invasive sperm retrieval or a redo vas reversal if blockage should occur. The good news is that it is very rare to need the sperm frozen at the time of vasectomy reversal (1). For doctors that charge extra to bank sperm, studies show that it is not usually cost-effective, meaning that for most that pay more to have sperm frozen, the sperm are rarely used (2).
Over more than 7000 thousand vasectomy reversals the doctors of ICVR have found that many men do not have fluid that is bankable during their vas reversal. Our andrologist can only bank and freeze sperm that has three out of three qualities.
1. good fluid volume,
2. high numbers of sperm and
3. high percent of sperm that are moving (motile).
We need to see all three to be able to bank fluid during a vasectomy reversal. This is unpredictable and can vary from person-to-person or even side-to-side.
During the vas reversal, we keep each patient’s partner up-to-date throughout the surgery as to what we find and whether or not the sperm we see are good enough to freeze. If a man requests sperm banking if at all possible, we can usually harvest sperm from the testicle but there are pros and cons with risks to this approach which are reviewed prior to the surgery (3).
There are two possible ways to use the patient’s own frozen and banked sperm.
Banked sperm can be used for two different assisted technologies, IUI or IVF.
If we get large volumes of fluid with very high counts and motility then this may be good enough for simply instilling the washed sperm up into the uterus on the day of ovulation. This is called “intra-uterine insemination” or IUI. This is relatively inexpensive, with up to a 15% chance for pregnancy per IUI attempt, depending on many male and female factors and sperm washing techniques. It is usually uncommon to get enough fluid volume, sperm counts and motility for IUI quality specimens during a vas reversal.
Smaller volumes of fluid or a lesser number or quality of sperm can sometimes be frozen to be used for “in-vitro fertilization” (IVF). IVF involves stimulating the female with high doses of hormones to get the ovaries to push out a large number of eggs that are then retrieved. The frozen sperm are then thawed and one sperm is then injected microscopically into each egg, which usually results in an embryo. These embryos are then placed into the uterus after an additional round of hormones. Though this is truly a modern miracle, it can be extremely expensive and there are added potential risks to the babies and mother (4). There are some couples that will not consider this for personal, financial or religious reasons.
If couples have any questions about sperm banking at the time of the vas reversal or any specific concerns, call us any time. Our team of professionals are here to answer any questions.
This page was reviewed, edited and updated June 13, 2023 by Sheldon H. F. Marks, MD.
References:
1.Glazier DB, Marmar JL, Mayer E, Gibbs M, Corson SL. The fate of cryopreserved sperm acquired during vasectomy reversals. J Urol. 1999;161:463–6.
2.Boyle KE, Thomas AJ, Jr, Marmar JL, Hirshberg S, Belker AM, Jarow JP. Sperm harvesting and cryopreservation during vasectomy reversal is not cost effective. Fertil Steril. 2006;85:961–4.
3.Schrepferman CG, Carson MR, Sparks AE, Sandlow JI. Need for sperm retrieval and cryopreservation at vasectomy reversal. J Urol. 2001; 166:1787–9.
4.Mainigi M, Rosenzweig JM, Lei J,. Mensah V, Thomaier L, Talbot CC Jr, Olalere D, Ord T, Rozzah R, Johnston MV, Burd I.Peri-Implantation Hormonal Milieu: Elucidating Mechanisms of Adverse Neurodevelopmental Outcomes. Reprod Sci. 2016;23(6):785–794.
