Q: What is sperm retrieval with reversal?
A: The rationale behind retrieving sperm at the time of reversal is to eliminate the need for future sperm aspiration for IVF if the reversal fails to produce sperm in the ejaculate. The sperm retrieved can only be used for IVF since only a small number of sperm are obtained. The usual cost with retrieval is $500-$750 as per the androlgy lab; there is no surgeon’s charge for this service.

Most men do not require sperm retrieval for the following reasons:

1. Routine vaso-vasostomy has a very high patency rate, 80-90% or higher, especially with a short obstructive interval. I personally do not believe the $750 spent on retrieving sperm in these men is a good investment since 80-90% of men will have no need for the retrieved sperm once they begin to ejaculate fresh sperm.

2. Sperm aspiration is easy and inexpensive; even if the reversal fails, it is no more costly to aspirate sperm later than to retrieve sperm initially. Granted, one does obviate having yet another, albeit minor, procedure done.

On the other hand, the case for retrieval can be made for those undergoing epididymo-vasostomy following extended obstructive interval since the patency will be significantly lower at 50-60%. In these men, we ask them to consider retrieval as an option; some insist on retrieval to avoid any future procedure while others have no problem with a “wait and see” approach.

Sperm may be retrieved by collecting the sperm containing vasal or epididymal fluid or by removing a small piece of testis tissue. The amount of testis removed is about 250 mg, about the size of 2-3 rice grains. It adds very little time to the procedure. Recovery is not much different than reversal without.

Arrangement for sperm processing and storage must be made with the andrology lab prior to procedure. We routinely refer specimen storage with Atlanta Center for Reproductive Medicine or Georgia Reproductive Specialists.