My Vasectomy Reversal

I’ve been wondering about our next steps if Rich’s post-vasectomy reversal sperm count doesn’t improve over his last semen analysis results.  One option is intracytoplasmic sperm injection or ICSI, another is a second attempt at vasectomy reversal. Of course, we could also try with donor sperm, or move towards adoption.  But I want to exhaust all reasonable efforts for a biological child before moving on to other options, so for now, we’ll set aside adoption and donor sperm. 

So which makes more sense – ICSI or a second reversal?

A study comparing sperm aspiration and ICSI to a second vasectomy reversal found that pregancy rates were 44% for repeat reversals, and cost was about $15,000; while the pregnancy rate with ICSI was 56% and cost was $35,500.  So even though the success rate is slightly higher with ICSI, the cost per delivery by  ICSI is 2 1/2 times more. 

This leaves me wondering if the higher success rate of ICSI is worth the extra cost.  I’m not sure Rich wants to go through another VR, although I’m sure microscopic epididymal sperm aspiration is no picnic, either.  And I’m not sure that I want to go through all the hormones and procedures needed for ICSI.  So what to do?  I guess right now we continue trying naturally and hope that the miracle of conception can happen twice.  When we reach one year past vasectomy reversal, we’ll make some decisions.

Related post:

• Vasectomy reversal success rate

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