Before You Have Your Vasectomy
Vasectomy is a surgical procedure for male sterilisation and as such a very effective way of preventing pregnancy. It is a procedure that should be considered as permanent. Research has shown that as many as 1 in 10 men later come to regret their decision and wish to have their vasectomy reversed for a variety of reasons. Assuming the procedure is successful it is considered a permanent birth control method and not easily reversed. There are a number of techniques which can be used to collect sperm after vasectomy including vasectomy reversal or surgical sperm collection. However, the success rates with vasectomy reversal depend on the skill of the surgeon performing the reversal and the time that has elapsed since the vasectomy was performed. Also, surgical sperm collection is an invasive procedure which must be used in conjunction with an IVF cycle. Therefore you may wish to consider sperm freezing prior to your vasectomy.
Why Consider Sperm Storage Before Vasectomy?
Men can freeze one or more samples of semen just before having their vasectomy performed. These samples can then be stored as a form of “reproductive insurance” in case life’s circumstances change and another child is wanted at a later date. This may remove the possible need for vasectomy reversal or assisted reproductive technology (ART) treatment at a later stage. It must be remembered that regaining fertility after vasectomy is neither easy nor cheap. Since 1996 in Australia, there is no rebate from Medicare for vasectomy reversals. There are Medicare rebates for fertility treatments when using frozen sperm or sperm retrieval procedures post vasectomy. In about half of cases, vasectomy reversal surgery does not enable couples to become pregnant naturally. In 40% of patients who have a vasectomy reversal sperm antibodies develop and therefore make the sperm less effective when trying to conceive. However if sperm has been stored before the vasectomy, at a fertility clinic the female partner can be inseminated at the mid-point of her menstrual cycle or the sperm used in an in vitro fertilisation (IVF) procedure.
What Are Sperm Antibodies?
After vasectomy, many men start to produce antibodies to sperm. Antibodies are proteins made in the body by the immune system to fight infection or disease. They attack anything in the body that is foreign (i.e. what is not part of the body). Often these antibodies do not cause a fertility problem but in some men they may be a problem for natural conception. Sperm antibodies can interfere with the ability of sperm to swim and to attach to eggs thereby preventing conception even if a vasectomy reversal is successfully.
The Practical Details Of Semen Freezing
If semen freezing is something that you would like to do prior to your vasectomy, you will need to get a referral from a doctor (GP or specialist). Semen samples are produced by masturbation either at your own home or at Fertility Solutions private collection room. If you are producing your sample at home the sample will need to be delivered to Fertility Solutions within 1 hour of being produced. Upon receiving the sample a scientist will examine the quality of the sample and assess if it is suitable for freezing. The scientist will then prepare the sample for storage, and then freeze it in liquid nitrogen.
Please refer to the Semen Freezing brochure for more information or contact Fertility Solutions to request a copy of this brochure to be sent to you.
A written report about the quality of the sample will be sent to your referring doctor and a letter outlining how many straws (storage device for storing semen) have been frozen and are in storage will be sent directly to you. If the sample is not suitable for freezing, we might recommend that you return to the clinic in a few days’ time for a re-assessment.
How Long Can It Be Stored For?
Please refer to our Position Statement on the Storage and Disposal of Gametes (Sperm and Eggs).
What If I Do Decide To Have A Child?
The chance of achieving a pregnancy with your frozen sample depends on the quality of the sample and the fertility of your partner (the largest predictor of this is the female age). Fertility rates with frozen samples are lower than with fresh semen, so we require that your partner be assessed by a fertility specialist.
The fertility specialist will then recommend one of the following options:
- Placing the sample in the woman’s uterus (womb) during the fertile time in her natural cycle (known as intra-uterine insemination (IUI)) or using fertility stimulating medicines to increase the chance of success with intrauterine insemination
- In-vitro fertilization (IVF ) where the semen sample is mixed with eggs obtained from the woman with a surgical procedure
- Intracytoplasmic sperm injection (ICSI) where individual sperm are injected directly into eggs obtained from the woman with a surgical procedure
How Much Does It Cost?
The following fees will apply for the assessment, freezing and storage of your sample:
Assessment: A complete assessment (or semen analysis) will be performed on the sample prior to freezing; this involves calculating the sperm concentration, motility, morphology and sperm antibodies. This assessment allows a Fertility Specialist to determine what possible treatment the sample would be suitable for use in the future if needed. The cost of this assessment can be obtained by phoning Fertility Solutions and speaking with administration prior to booking your appointment.
Freezing & Storage: The freeze and storage fee will include freezing of the sample and the first 6 months storage (or part thereof). Subsequent storage costs will be calculated every 6 months and these fees can be obtained by phoning Fertility Solutions and speaking with administration prior to your appointment.
Fees will also apply for fertility treatments if the sperm is used, or if the samples are transferred to another fertility clinic at your request.
Creating A Will
When you sign the Consent for your semen to be frozen and stored it is very important that you have a WILL made or amend your WILL to indicate your intentions for use or disposal of your reproductive tissues (semen) in the event of your and/or your partner’s death.
Particularly, you should indicate your agreement (or otherwise), that your partner or family have future access to these tissues in your absence.
What Do I Need To Do Next?
If you decide that you would like to freeze sperm prior to vasectomy, you will need to contact your GP/specialist to arrange for a referral to Fertility Solutions for a semen analysis and semen freeze. After this you will need to phone Fertility Solutions to arrange an appointment for sperm freezing. At this appointment you will be required to sign consents and be given an opportunity to discuss any further questions.