IVF / ICSI is better: Congenital bilateral absence of the vas deferens means that he'll need a surgical sperm retrieval, usually pesa or percutaneous epididymal sperm aspiration, done by a urologist. Pesa is simpler than testicular retrieval but still carries some risk of scarring/ damage. 1 pesa may yield enough sperm for 1-2 IUI attempts; ivf with icsi has a much better success rate with surgically retrieved sperm.
Answered 8/11/2015
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