The advent of intracytoplasmic sperm injection has revolutionized the treatment of male infertility and offers an alternative to vasectomy reversal as a treatment option for postdash;vasectomy infertility. Issues including morbidity, cost and therapeutic outcomes are, however, important considerations for both treatment options. Vasectomy reversal should be considered the ideal option for couples less than 15 years since vasectomy, couples interested in more than one child, couples without indash;vitro fertilization insurance coverage and couples with no interest in assisted reproductive techniques. Intracytoplasmic sperm injection may be considered as the primary option for those couples with an older female partner especially if bilateral vasoepididymostomy may be required. Curr Opin Urol 8:531ndash;534. copy; 1998 Lippincott Williams amp; Wilkins
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