After a man has been sterilised, it is often technically possible to restore his fertility via a repair operation. Before proceeding with a repair operation, the fertility doctor will briefly check whether the couple’s general fertility is in order.
Practical info : after the examination by the fertility doctor you will be referred to the urologist. He will discuss the arrangements for the operation with you. He will explain that if there has been a long time between sterilisation and the repair operation, there is a good chance that sperm antibodies will form that may block sperm function. There is also a chance that the repair operation will fail (due to the formation of adhesions). It is therefore often useful to take and freeze a small biopsy from the testicle at the time of the repair operation. This will usually contain usable sperm cells that can be used via an IVF procedure should the repair operation fail or the woman still not become pregnant.
Chance of pregnancy after repairing the seminal tubes
Three months after the repair operation, the ejaculate will once again contain sperm cells. If these are of sufficient quality there is a good chance of pregnancy. On average, two out of three women in couples in which the man has undergone a repair operation will become pregnant spontaneously; provided no abnormalities were found in the woman in the prior fertility examination.
If the woman still does not become pregnant, or if too many antibodies form in the man, or if the sperm cells from the ejaculate are not of sufficient quality, IVF-ICSI may be an alternative. With the ICSI procedure the biologist will select a sperm cell and use this to fertilise an egg in the woman.
If no sperm cells appear three months after the repair operation, the frozen testicle biopsy can be thawed. The sperm cells this contains can then be used for an IVF-ICSI procedure.