Conceiving After a Vasectomy: What are the choices?


Your husband had a vasectomy and now you both decide that you want to have children. Your friends tell you that you have to adopt because vasectomy reversal either is very expensive or doesn't always work. Is adoption truly your only option?

You actually have three options: vasectomy reversal, a procedure called microscopic epididymal sperm aspiration (MESA) followed by intracytoplasmic sperm injection (ICSI) and in-vitro fertilization (IVF), or adoption. Assuming that you want to have a biological child, the first two options are the only ones open to you at this point.

Option #1: Vasectomy Reversal
Vasectomy reversal, although it tends to have a bad name, does work. One study showed that 78% of the procedures they performed ended in a pregnancy. Obviously some of the time, vasectomy reversal does not work. In terms of cost, this study put the average cost per delivery per couple in the case of vasectomy reversal to be $14,892.

Option #2: MESA/ICSI/IVF
Don't worry if this alphabet soup seems to be confusing. MESA stands for microscopic epididymal sperm aspiration, which means that sperm are removed from the man. Remember that having a vasectomy means only that sperm are not ejaculated, not that sperm are no longer made. MESA is followed up by ICSI (intracytoplasmic sperm injection) and IVF (in-vitro fertilization). This means that the sperm that are collected from the man are then used to fertilize some eggs from the woman, which are then implanted in her uterus. The pregnancy rate for MESA/ICSI/IVF was 67% and only 56% reported delivery. The average cost per delivery for MESA/ICSI/IVF was $35,570.

Option #3: Adoption
Adoption, while certainly a good thing to look into, may take some time. The amount of time and money involved will vary a great deal depending on the specifics of where you live and where the child is coming from. The entire adoption process can take anywhere from one to nine years. There are also some legal fees involved, although these typically are not as steep as the price tags for either of the above options.

The Bottom Line
What you decide to do depends a great deal on how much time and money you are willing to put into your efforts to have a child. The best bet is to meet with you doctor to determine the actual cost of either a vasectomy reversal or MESA/ICSI/IVF. Develop a timetable with your doctor so that you will know how long the entire process will take. Then look into adoption to find out how expensive it is and how long it would probably take. Use these estimates to make your decision.

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