Vasectomy reversal versus IVF with sperm retrieval: which is better?

@article{Shridharani2010VasectomyRV,
  title={Vasectomy reversal versus IVF with sperm retrieval: which is better?},
  author={Anand Shridharani and Jay I Sandlow},
  journal={Current Opinion in Urology},
  year={2010},
  volume={20},
  pages={503–509}
}
Purpose of review This paper will describe why this review is timely and relevant. Over the past two decades, treatment options for couples with reconstructible obstructive azoospermia have improved tremendously. Advances in assisted reproductive technologies (ART), specifically sperm retrieval techniques for intracytoplasmic sperm injection coupled with in-vitro fertilization, as well as refinements in microsurgical reconstruction have led to improved outcomes and cost-effectiveness. Providing… 
View on Wolters Kluwer
ncbi.nlm.nih.gov
31 Citations
Highly Influential Citations
1
Background Citations
15
Methods Citations
1

31 Citations

A single-center study examining the outcomes of percutaneous epididymal sperm aspiration in the treatment of obstructive azoospermia
TLDR
Outcomes obtained using fresh and frozen PESA-derived spermatozoa were similar and as such, either could be used during the IVF process.
Predictive factors for sperm retrieval and sperm injection outcomes in obstructive azoospermia: Do etiology, retrieval techniques and gamete source play a role?
TLDR
A review of obstructive azoospermia and assisted reproduction techniques is presented, highlighting the most relevant aspects of the decision-making process for use in clinical practice.
Clinical Andrologists: Do We Really Need Them in the Era of ART?
Infertility is on a rise, and so is the availability of assisted reproductive technique (ART) centres. The sole aim of these centers is to help these unfortunate couples achieve pregnancy. Hence, the…
Surgical techniques for the management of male infertility.
TLDR
Clinicians treating infertility should advocate for couple-based therapy, and require that both partners have a thorough evaluation and an informed discussion before undergoing specific surgical therapies.
Vasectomy in Male Contraception and its Reversal
Andrology - reproductive years and beyond.
  • E. Chung
  • Medicine
    Australian family physician
  • 2012
TLDR
There is increased evidence for the role of microsurgery in sperm retrieval, varicocelectomy and vasectomy reversal in men seeking paternity, and therole of testosterone replacement therapy and erectile dysfunction.
Vasectomy reversal semen analysis: new reference ranges predict pregnancy.
Challenges in completing a successful vasectomy reversal
TLDR
A pre‐operative management algorithm is discussed in men seeking vasectomy reversal to ensure appropriate counselling with a thorough pre-operative history, physical examination and on occasion, hormonal evaluation.
The Impact of Maternal Age on Intracytoplasmic Sperm Injection (ICSI) Outcomes in Infertile Couples
TLDR
The study showed that females whom their age more than 35 years produced significantly lower oocytes number with a lower fertilized oocytes when compared with females younger than35 years, indicating that the maternal age is one of the most important predictor of ICSI outcomes.
When is azoospermic infertility treatable without intracytoplasmic sperm injection?
Infertility with azoospermia requires a diligent search for reversible factors and treatment to restore natural fertility, even though most cases are due to untreatable primary spermatogenic failure…
...
...

References

SHOWING 1-10 OF 53 REFERENCES
The best infertility treatment for vasectomized men: assisted reproduction or vasectomy reversal?
In men with prior vasectomy, microsurgical reconstruction of the reproductive tract is more cost-effective than sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection if the…
Surgery or assisted reproduction? A decision analysis of treatment costs in male infertility.
TLDR
A decision analysis based comparison of ART and classic surgical therapy suggests that varicocelectomy and vasectomy reversal are the most economical treatments in many cases of infertility due to these lesions.
A decision analysis of treatments for obstructive azoospermia.
TLDR
Vasectomy reversal appears more cost-effective than percutaneous TESE and MESA for treatment of obstructive azoospermia when the impact of indirect costs is considered and the absolute cost-effectiveness of all therapies improved over time.
Results in the United States with Sperm Micro-Aspiration Retrieval Techniques and Assisted Reproductive Technologies
Reassessing reconstruction in the management of obstructive azoospermia: reconstruction or sperm acquisition?
Should vasectomy reversal be performed in men with older female partners?
Fertility options after vasectomy: a cost-effectiveness analysis.
Clinical review 87: In vitro fertilization for male factor infertility.
TLDR
For couples with male factor infertility, careful evaluation and treatment of the man should be considered before assisted reproduction, including ICSI, and several important questions remain with regard to IVF-ICSI.
Use of surgical sperm retrieval in azoospermic men: a meta-analysis.
Microsurgical Vasovasostomy versus Microsurgical Epididymal Sperm Aspiration/Testicular Extraction of Sperm Combined with Intracytoplasmic Sperm Injection
TLDR
Even in the era of ICSI, microsurgical VVS represents the standard approach for obstructive azoospermia following vasectomy and MESA/ICSI should be reversed for patients who are not amenable for micros surgical reconstruction based on a cost–benefit analysis.
...
...