Sperm Retrieval and Sperm Banking

Dr. Turek routinely offers sperm retrieval and sperm banking at the time of vasectomy reversal. In complicated cases or previously failed vasectomy reversals, patients may desire sperm retrieval and banking of moving sperm tapped from an epididymal tubule before the microsurgical reconnection is performed. Importantly, sperm needs to be moving or motile for sperm retrieval to be valuable. Motile sperm during sperm retrieval are found most commonly (a) behind a vasectomy site that is < 3 years old, or (b) during epididymal exploration for epididymovasostomy.

Please remember that the decision to perform vasovasostomy or epididymovasostomy is based on the presence of ANY sperm at the testis end of the vas deferens (see Table above), either non-moving or moving. Thus, when non-moving sperm are found at the vas deferens during vasectomy reversal, sperm retrieval is not worth it as the sperm are likely dead. Also, it is generally not advisable to “search” for moving sperm in the epididymis to allow sperm retrieval, if the “searching” commits the surgeon to a more complicated vasectomy reversal surgery than would otherwise be needed. (Complicating vasectomy reversal surgery tends to lower success rates.) In general, testis sperm retrieval can be done with testis sperm extraction (TESE) by biopsy during any type of vasectomy reversal. Given the very high chance of having moving sperm in the ejaculate after Dr. Turek’s vasectomy reversal procedure, most patients will consider sperm retrieval if they expect that an epididymovasostomy is needed. If a couple would not consider using assisted reproduction in the future (which is precisely what sperm retrieval requires to be successful), then Dr. Turek does not recommend that couples bank undergo sperm retrieval during vasectomy reversal. In this case, sperm retrieval and banking is an insurance policy that has little value. There is an additional charge for sperm retrieval and banking at the time of vasectomy reversal.

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