Routine Sperm Cryopreservation Before Vasectomy Is not Cost-effective and Does not Increase Live Birth Rates Compared...

Area of Science:

• Reproductive Medicine
• Health Economics
• Urology

Background:

• Men undergoing vasectomy may later desire additional children, necessitating fertility restoration.
• Sperm cryopreservation before vasectomy and fertility restoration are options for preserving reproductive potential.
• The comparative cost-effectiveness of these approaches is not well-established.

Purpose of the Study:

• To compare the cost-effectiveness of routine pre-vasectomy sperm cryopreservation versus fertility restoration for men desiring future children.
• To evaluate live birth rates associated with each fertility preservation strategy.

Main Methods:

• A scoping review identified data on cryopreservation, vasectomy reversal, surgical sperm retrieval, and assisted reproductive technologies (ART).
• Cost data were gathered from US facilities for cryopreservation and andrology care.
• A cost-effectiveness model analyzed cost per live birth and overall live birth rate.

Main Results:

• Pre-vasectomy cryopreservation incurred significantly higher costs ($140,247 per live birth) than fertility restoration ($20,458 per live birth).
• Pregnancy success rates were higher with fertility restoration (62%) compared to cryopreservation (46%).

Conclusions:

• Routine pre-vasectomy sperm cryopreservation is more costly and does not enhance live birth rates compared to fertility restoration.
• Fertility restoration is a more cost-effective strategy for men seeking future fertility post-vasectomy.
• Patients should be counseled on the costs and ART requirements of pre-vasectomy cryopreservation.