A vasectomy reversal is a surgery that involves re-connecting the vas deferens with the goal of restoring fertility after someone has had a vasectomy. There are many reasons people may consider getting a vasectomy reversal. Maybe you and your partner miss the baby stage or decide you want to delay becoming an empty nester. Maybe you get remarried and decide to try to have a baby with your new partner. Life happens! Those are all totally understandable reasons and we will break down everything you need to know!
Some men fall into the trap of seeing a vasectomy as a temporary, convenient form of birth control and think that they can just get it reversed in the future without any problems. A vasectomy reversal is more complicated than a vasectomy, involves slightly more risk, and lastly, it is not guaranteed to work. So, if you desire children in the future, other more temporary forms of birth control should be explored!
Understanding Vasectomy Reversal
A vasectomy reversal is a procedure usually performed in the operating room. If it is performed in the operating room, you would most likely be able to go home the same day. Depending on the surgeon, one or both sides are re-connected.
After the incision is made, the surgeon will use a surgical microscope to help them see everything up close. They will find both parts of the vas deferens and assess the tubes. If both parts of the tubes are healthy and don’t have a lot of scar tissue around it, they can just be reconnected. This is called a vasovasostomy. The lumen of the vas deferens is restored allowing sperm to reach the ejaculate again.
Sometimes, the vas deferens has to be re-connected to the epididymis, which is where sperm mature and are stored. This is a more technically challenging procedure and only performed if there is an issue with reconnecting the vas deferens OR if there is some sort of other obstruction of the vas deferens or epididymis.
The decision on the form of reconnection cannot be made until the surgeon is in the procedure and able to assess your anatomy.
In general, the recovery would be similar to a vasectomy. You would be sore for a few days and have to take it easy to avoid strenuous activity for a couple of weeks.
Success Rates and Factors Influencing Outcomes
The success rates for vasectomy reversal can be a bit confusing because it means different things depending on the context.
How successful is the procedure in returning sperm to the ejaculate? Highly successful, actually, with 85-90% chance of having return of sperm in the ejaculate.
However, many people such as yourself reading this article might define success as the ability to get pregnant after this procedure. That is unfortunately a little bit lower at around 30-60%. There are many reasons for this, which we will discuss below!
Time since vasectomy
The sooner the better!! There is no time cut-off after a vasectomy that would limit you from being able to have it reversed. However, highest chances of success occur for patients who had their vasectomy less than 10-15 years ago. The body goes through a lot of changes after an “insult” such as a procedure like a vasectomy. These changes can lead to progressive damage of the structures that make and store the sperm, which can definitely impact the sperm and affect pregnancy rates.
Age of the patient/partner
The age of both the patient and partner may play a role in the success of a vasectomy reversal. Multiple studies have found lower rates of pregnancy in certain age groups once women are over the age of 40. This is due to the fact that the natural fertility of women tends to decline with age.
It was previously thought that the older that men were, the less chances they had at success with a vasectomy reversal. However, a recent study from the University of Southern California found there were no differences in pregnancy rates after a vasectomy reversal when comparing groups of men below and over 50 years old.
Surgeon’s experience and technique
This procedure is extremely delicate and requires operating under a microscope. The stitches used can be finer than a piece of hair! It is important that you find a surgeon who is very experienced with this procedure and does them often. The surgeon must be skilled enough to be able to preserve as much blood supply to the vas deferens as much as possible and be able to identify the presence of an obstruction. These are two things that could contribute to surgical failure.
Possible Complications and Risks
The risks and possible complications of a vasectomy reversal are inherently higher than that of a vasectomy.
The main reason for this is that a vasectomy reversal does typically require general anesthesia. While the risks are very low, general anesthesia can be associated with heart attacks and blood clots in the legs, lungs, or brain.
The other risks after surgery are similar to that of a vasectomy. There is a risk of infection at the surgical site, bleeding/hematoma within the scrotum, or chronic pain.
Alternatives to Vasectomy Reversal
The other alternative to a vasectomy reversal is sperm retrieval. This is a procedure that involves taking sperm directly from the testicles, where they are made, or the epididymis, where they mature and are stored. The sperm retrieval is either combined with intracytoplasmic sperm injection/ICSI or in-vitro fertilization (IVF).
This would require both partners to undergo procedures, can be very expensive, and there are many different factors that play into if they will be successful.
Conclusion
If you’ve previously had a vasectomy, but changed your mind and want to explore options for being able to have another biological child, there are a few things that can be done to help out with that!
The first is a vasectomy reversal, which is a procedure that involves reconnecting the vas deferens or the vas deferens to the epididymis to allow sperm to reach the ejaculate again. Even if the procedure is successful, it unfortunately does not always lead to pregnancy. Other alternatives may include sperm retrieval, which can then be used to fertilize an egg during IVF. With both methods, the restoration of fertility does also depend on the female partner.
If you are interested in any of these options, make sure you do a lot of research to choose a highly skilled surgeon who is knowledgeable and can give you the best chances at success. Purely Vasectomies is happy to help you in any way we can.
