One common question with vasectomy reversals is, “Should I get a vasectomy reversal if my partner is older?” This is a difficult question to answer, since there are several things which must be considered. Some of these factors include:
- Anticipated decline in natural fertility among women beginning at age 35 and above
- Decrease in efficacy with IVF/ICSI beginning at age 35 (rough estimate is 30-40% live birth rate at age 35, 5-10% at age 40, 0% at age 45).
- Cost considerations between IVF and reversal
- Number of IVF cycles which may be considered – i.e. if the reversal is successful with good long-term returns of sperm, pregnancy can be attempted each month vs a set number of attempts with IVF
- Pre-implantation genetic testing is an option with IVF
- Anticipated average times to pregnancy (with reversal 12-17 months vs more rapid with IVF)
Because of the complexity of this question, you may wish to reach out to both an IVF and reversal specialist if you are unsure of how you wish to proceed. Just realize that if you speak to a reversal specialist, they will naturally be biased towards a reversal, and IVF specialists will be more likely to recommend IVF. However, often, they can help you recognize which factors are most important for you to help you make a decision. And in some cases, patients elect to proceed with both a vasectomy reversal and IVF.
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