Having Children After A Vasectomy
Traditionally, birth control is mainly a woman-focused conversation. Common methods like the pill, implants, and even emergency contraception are almost exclusively aimed at women. However, both genders have access to permanent options, including tubal ligation for women and vasectomy for men. Often viewed as ideal for people who are finished with family planning, the reality is that feelings can change. A couple may decide to try again for another baby, or relationships may change, and building a family with a new partner may be desired. What options are available to men who have had a vasectomy but now want more children?
Can vasectomies be reversed?
Although referred to as permanent solutions by the average person, men can have a vasectomy reversed. Traditionally, the process involved a surgery known as vasectomy reversal, which is usually performed as an outpatient operation. During the procedure, a surgeon works to reconnect the vas deferens or tubes that transport sperm from the testicles to mix with the semen. Experts recommend that this type of process be performed by a surgeon experienced with using a surgical microscope because of the small size of the vas deferens. Success rates can range from 30-90% depending on a wide range of factors, including time since the original surgery was performed, a man’s age, current fertility status, and the surgeon.
Vasectomy workarounds
Not every man wants to undergo a vasectomy reversal, especially given the varying success rates associated with the surgery. A microsurgical epididymal sperm aspiration (MESA) is a less invasive alternative that can retrieve sperm from the epididymis, a duct located behind the testes. The procedure is usually reserved as a solution for people relying on fertility treatments such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) to get pregnant.
MESA and ART treatments
Usually, a man with a vasectomy seeking MESA is planning to participate in assisted reproductive technology (ART) fertility treatments. The timing of the procedure will depend on whether the individual is participating in active treatment. For example, a man pursuing IVF with a partner will usually be encouraged to time MESA sperm retrieval around the same time that egg retrieval is scheduled. Alternatively, if a man is looking to preserve sperm in the hopes of use at a future date, a fertility specialist may recommend cryopreservation.
What people should know
MESA, as a method of sperm retrieval, is not a cure-all solution for a man struggling with sperm quality issues. Even though the process can be used as part of fertility treatments, the method won’t correct for factors like poor motility, shape, or general deoxyribonucleic acid (DNA) quality. Still, for men who are rethinking family planning and want to try again, MESA is an alternative solution to try for more children that’s less invasive than surgical vasectomy reversals.
