Changes in your life or relationships may cause you to want to have a child after a vasectomy. In many cases vasectomies can be reversed. It’s important for men to have an honest discussion with their partner to decide if having a vasectomy reversal is the best choice for them. If your female partner is older than 40, it may be harder for you and your partner to conceive naturally. In these cases, couples may be better served by having a procedure to extract sperm, which can be used for in-vitro fertilization (IVF). Sometimes doing both a vasectomy reversal and sperm extraction at the same time is the best choice to optimize success of achieving pregnancy.
Vasectomy Reversal Procedures
Surgeons generally use two procedures to reverse vasectomy:
- Vasovasostomy
- Vasoepididymostomy
Vasovasostomy
Vasovasostomy is the most common technique for vasectomy reversal. During this three-hour procedure, your surgeon will sew the cut ends of the vas deferens tubes back together using sutures that are finer than a human hair. We want to make sure your tissue is handled extremely carefully. We use a high-power surgical operating microscope that magnifies 30-40 times. Before placing any stitches, your surgeon will examine the fluid coming from the end of the vas deferens still attached to the testicle. We will only perform a vasectomy reversal if fluid is still present at the time of surgery. If you don’t have any fluid, we will perform a vasoepididymostomy.
Vasoepididymostomy
Vasoepididymostomy is a more complex version of the vasovasostomy. This involves connecting one end of the vas deferens directly to the epididymis, which is a structure that stores sperm created in the testicle. Surgeons will choose this procedure if your sperm is getting blocked in your epididymis. We typically use the intussusception technique, which involves placing two or three sutures in a tubule within the epididymis and then connecting them to the vas deferens before opening the tubule.
Vasectomy Reversal FAQS:
How much does a vasectomy reversal cost?
Typically, insurance doesn’t cover vasectomy reversal. It depends on where you live, but at our institution it costs $8,000 in total, including consultation, surgery, and anesthesia.
What is the recovery from the surgery?
Vasectomy reversals are performed under general anesthesia. You will go home the same day after surgery. Patients typically have minimal pain. Most men can manage their pain by using over-the-counter pain medications and ice packs. After surgery, we ask that patients avoid lifting anything heavier than a gallon of milk and don’t have sex or masturbate for two to three weeks.
What are the advantages to vasectomy reversal over IVF?
Vasectomy reversals are much less expensive than IVF. Also, it is possible for you and your partner to have multiple pregnancies after a vasectomy reversal. With IVF, each cycle is designed to result in only one pregnancy and birth.
What are the success rates?
Vasectomy reversal surgeries are usually successful in the hands of fellowship-trained microsurgeons who regularly perform them.
Vasectomy Reversal Success Rates
|
Vasectomy Reversal Success Rates. |
|
|
TECHNIQUE |
POSITIVE SEMEN ANALYSIS |
|
Vasovasostomy |
90-95% chance of sperm returning to ejaculate |
|
Vasoepididymostomy |
75% chance of sperm returning to ejaculate |
What factors affect the success rate of vasectomy reversal?
- Which technique is used
- Your surgeon’s skill level
- How long it’s been since you had your vasectomy
- The quality of your vasal fluid
- Whether you have any blockage in your epididymis
Does a successful vasectomy reversal mean we will get pregnant?
Some men have no or few sperm even if their vas deferens are successfully reconnected. Scarring, chronic congestion, or anti-sperm antibodies can cause men to have few or no sperm. If your vasectomy reversal fails or your sperm counts remain low, you will probably need IVF or an alternative reproductive technology.
Should I store my sperm in a sperm bank?
We can collect sperm during a vasectomy reversal by making a small incision in your testicle to remove some of the tubules. Sperm from the tubules can be frozen and kept in a sperm bank for as long as you’d like. The sperm can then be used for IVF in the future if vasectomy reversal is not successful or if your partner has fertility issues that require IVF.
