title: The best infertility treatment for vasectomized men: assisted reproduction or vasectomy reversal?
abstract: In men with prior vasectomy, microsurgical reconstruction of the reproductive tract is more cost-effective than sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection if the obstructive interval is less than 15 years and no female fertility risk factors are present. If epididymal obstruction is detected or advanced female age is present, the decision to use either microsurgical reconstruction or sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection should be individualized. Sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection is preferred to surgical treatment when female factors requiring in vitro fertilization are present or when the chance for success with sperm retrieval and intracytoplasmic sperm injection exceeds the chance for success with surgical treatment.
authors.affiliation: Department of Urology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo - São Paulo/SP, Brazil. fabio@conception-rs.com.br
authors.forename: Fábio Firmbach
authors.initials: FF
authors.lastname: Pasqualotto
authors.forename: Antônio Marmo
authors.initials: AM
authors.lastname: Lucon
authors.forename: Bernardo Passos
authors.initials: BP
authors.lastname: Sobreiro
authors.forename: Eleonora Bedin
authors.initials: EB
authors.lastname: Pasqualotto
authors.forename: Sami
authors.initials: S
authors.lastname: Arap
mesh_terms: D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000628:therapy*; D007247:Infertility, Female / Q000628:therapy; D007248:Infertility, Male / Q000628:therapy; D008297:Male; D020554:Sperm Injections, Intracytoplasmic; D014659:Vasectomy; D014669:Vasovasostomy