PESA and TESA Sperm Aspiration and ICSI vs. Vasectomy Reversal Surgery

Sperm can be aspirated from the testicle or the vas deferens (near the testicle) with minimal discomfort. This procedure, known as PESA or TESA, is performed under local anesthesia and typically takes about 30 minutes.

• PESA: Percutaneous Epididymal Sperm Aspiration
• TESA: Testicular Sperm Aspiration
• TESE: Testicular Sperm Extraction (requires a small incision, often performed in a hospital)

Costs range from $3,000 to $12,000 depending on various factors, including the location (office vs. hospital) and the type of anesthesia. Currently, AFCC charges $3,300 for sperm aspiration performed in-office, which includes urologist fees, facility fees, sperm freezing, and six months of storage.

The cost of ICSI at AFCC is $1,500, and IVF is $10,000. This includes ovarian stimulation monitoring, all IVF procedures, and anesthesia. More details on pricing plans can be found on our IVF costs and pricing page.

Success depends largely on the IVF lab's live birth rates and the age of the female partner. We generally expect similar or slightly higher success rates compared to other couples undergoing IVF with female partners of the same age. The female partner's ovarian reserve, measured by antral follicle count, is a good predictor of success.

Vasectomy reversals are more successful if performed within 10 years of the initial procedure, after which success rates decline. The surgery typically costs $10,000 to $15,000 and is performed by a urologist.

• Advantages: If successful, no further medical assistance is needed for future pregnancies.
• Disadvantages: High cost and possible need for additional birth control or sterilization if only one more child is desired.

Donor sperm insemination is a straightforward process in which frozen donor sperm is thawed and placed in the uterus at ovulation time. Couples can select a donor from a certified sperm bank.

Vasectomy reversal may be the best initial option for couples with a relatively young female partner and a recent vasectomy. For females over 35, a fertility evaluation should precede any procedure. If reversal surgery is unsuccessful, sperm aspiration with IVF-ICSI may be more effective.

• It’s often beneficial to consult both a reproductive endocrinologist and a urologist.
• General urologists may not be familiar with IVF-ICSI, and reproductive endocrinologists do not perform vasectomy reversals, so a team approach may be ideal.