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  1. JBG614
  2. Infertility Discussion
  3. Sunday, 13 October 2013
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My husband is 48 years old, and had a vasectomy almost 10 years ago. We met and got married 2 years ago, and now want to have a child. I am 32 years old.

I've done a lot of research, and the more I research, the more confused I become when looking at reversal vs. IVF vs. TESE/PESA/MESA and a million other options.

How do my husband and I decide? Cost is important to us, as we are not super wealthy, but I'd prefer to do the treatment that has the most chance for success. Ultimately we only want one child, maybe two at most, so reversal sounds daunting and seems to have low success due to my husbands age.

What might you suggest?
Responses (1)
DrNorian Accepted Answer Pending Moderation
Many factors go into deciding which method would be best for you and your husband. In a nutshell, I would recommend proceeding with an IVF cycle with a sperm aspiration (likely a PESA or MESA) procedure for your husband. This would give two of you the best chance for pregnancy. There are several reasons for this.

Because your husband has had a long interval between when he had the vasectomy performed and now, the likelihood that a vasectomy reversal would work is decreased. An interval under 3 years is optimal, above 8 years (similar to your husband) is not.

Another important factor that you bring up is how many children that you would like to have. If your desire is for over 3 children,a reversal may be reasonable in that if it were successful it should remain that way. If you would like 1 or 2 children, IVF with sperm aspiration would allow for the shortest time to pregnancy.

Lastly, many of the success rates quoted for vas reversals determine success just by having some sperm present in the ejaculate, albeit often extremely low numbers. In addition, the quoted success rates are often over a 3+ year period which doesn't factor in a female partner's age. We know that female age begins to affect the chance of pregnancy between 33 to 35 years old. A vas reversal would be more appropriate for a younger woman as opposed to a woman in her mid- to late-thirties.

Hope this helps! Please schedule an appointment with me to discuss these topics in more detail.

Best of luck,
John Norian
  1. more than a month ago
  2. Infertility Discussion
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