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Sperm Extraction During Vasectomy Reversal – Who Benefits?

Sounds good. Couples exploring the subject of vasectomy reversal will read many web sites from all over the world. One of the seemingly attractive ad-ons to the procedure is sperm extraction. ‘If the reversal doesn’t work then at least we have benefitted because we have extracted some sperms that you can then use’ is the line. There is a cost, often £400 or so (plus storage charges etc.) which is added to you bill. But is this a good idea?

Using the sperms requires IVF You would think that it should be possible to just implant the sperms into your partner in a simple way like artificial insemination and try to conceive that way. The reality however is that the number of sperms recovered is low, in the region of one million or so. Sounds a lot? Not really, the number of sperms in a normal ejaculate is 80 million per ml, or 160 million in total. So, our million sperms extracted is too small a number for conventional fertilisation and so requires a variety of IVF called ICSI to be effective.

Extracting sperms damages vital tubes.


This is a diagram of the testis and the tiny narrow sperm collecting tube, the epididymis which lies on top of the testis.  Sperms mature in the epididymis, starting out as just a head then developing a rudimentary tail finally becoming the full swimming missile over the course of 2 months. The epididymis is 6 meters long and 0.2 millimeters in diameter, a fragile tube indeed.

Following vasectomy the epididymis is packed full of sperms and dead sperm debris, acting like a blown up bag or reservoir of sperms. Sperm extraction (PESA) is done by pushing a large bore needle through the skin and into the epididymis. It is possible, indeed likely that needling the epididymis in this way can rupture the epididymis and causes a blockage or ‘blow out’. Blow out is a scar that blocks the passage of sperms through the epididymis, preventing them reaching the vas which leading to failure of the reversal. So sperm extraction (PESA) may lead to failure of your reversal.

So when is better to do sperm extraction?

Only when all hope of successful surgery have been exhausted.  In the many UK reversal doctors outside this clinic do not test the fluid in the vas for early detection of ‘blow out’ so they don’t know at the time of reversal if this blockage has occurred. In fact we don’t recommend sperm extraction until the semen tests have been performed after reversal, until you have decided that IVF (ICSI) is for you and and you have chosen, after further research of course, your favoured IVF clinic.

Your decision is Ultimate

of course if you are still keen on harvesting the sperm during the reversal, unfortunately we are not attached to a fertility clinic. We can guide you to go to another centre where this facility is available.

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