Experts consider efficacy of fertility restoration vs sperm cryopreservation

In this video, Bradley Roth, MS4, and Scott D. Lundy, MD, PhD, HCLD, consider some of the reasons that fertility restoration was found to have higher pregnancy success rates compared with sperm cryopreservation in the study, “Routine Sperm Cryopreservation before Vasectomy Is Not Cost-Effective and Does Not Increase Live Birth Rates Compared to Surgical Sperm Retrieval or Vasectomy Reversal.”

Roth is a fourth-year medical student at the University of California, Irvine Medical Center, and Lundy is the section head of reproductive urology as well as a surgeon scientist at the Cleveland Clinic in Cleveland, Ohio.

Video Transcript:

Roth: I'll let Dr. Lundy speak most on this because he actually performs these procedures, but I think a lot of it is the fact that urologists have gotten very good at vasectomy reversals, so the success rate from a surgical standpoint is very good. While there is a surgery that's involved in it vs just banking sperm, it tends to portend very good outcomes for these patients in terms of restoring fertility. The other thing that has to be kept in mind is that patients who are cryopreserving sperm, whatever theoretical future female partner they may have will have to undergo IUI or IVF or some sort of assistive technology, so that may be contributed to the discrepancy in success rates. But I'll let Dr Lundy expand upon that.

Lundy: I think it's important to recognize that if you freeze sperm before your vasectomy, that sperm is only good enough for IVF or occasionally for intrauterine insemination, both of which are procedures that cost additional money and have variable success rates. On the other hand, a vasectomy reversal in particular allows for natural conception for these couples and avoiding any of the costs and challenges associated with IVF. A big benefit of pursuing this approach is to allow for a spontaneous pregnancy, and in many cases, multiple spontaneous pregnancies, as couples have more than 1 child down the road. It is important to know that the success rates are based upon the best available data, which admittedly is limited for this population. While I would hesitate to say that reversal is truly better in terms of efficacy, I think this data suggests that it's at least as good, with our 90 plus percent success rates with the surgery in terms of restoring sperm to the ejaculate. We then also have to consider the female factor and how old the female partner is and whether she's had children before in our decision-making as well.

This transcript was AI generated and edited by human editors for clarity.