Generations Fertility Care program in Madison, Wisconsin offers microsurgical vasectomy reversal for those men who have undergone a vasectomy and later decide they would like to initiate a pregnancy.
For men who have had a vasectomy and later decide they would like to have a vasectomy reversal in order to initiate a pregnancy, there are two primary options:
- Microsurgical vasectomy reversal
- Sperm retrieval
Fertility specialists will work with the couple to determine the most appropriate method for helping them to achieve pregnancy.
For a man whose female partner is over the age of 40, or in cases where there is a diagnosed female fertility problem, the fertility specialists may recommend a combination of sperm retrieval techniques and In Vitro Fertilization (IVF) to achieve pregnancy.
If there are no complicating factors, then a vasectomy reversal may be a suitable option.
Dan Williams, MD, discusses the microsurgical vasectomy reversal procedure.
Vasectomy reversal is a more elaborate procedure than the original vasectomy. The vasectomy reversal procedure is performed under general anesthesia in an outpatient surgery setting. Typically the procedure lasts about two hours on each side.
During a vasectomy reversal, the surgeon essentially reconstructs the vas deferens tubes, which were cut during the original vasectomy procedure. During the reversal, our fellowship-trained microsurgeon uses an operating microscope to offer patients the best possible outcome.
In addition to the routine reversal, sometimes men will have scar tissue or it has been a long time since their vasectomy and it is not possible to reconstruct the vas deferens. If that occurs, a "bypass procedure," or epididymovasostomy, will be performed. The surgeon bypasses the vasectomy site and reconstructs the vas deferens directly to the side of the testicle. The bypass procedure can only be performed with an operating microscope by someone with specialized microsurgical training.
Because it isn't possible to know what type of reconstruction will be necessary until the procedure is performed, it is important that the surgeon be trained in the bypass procedure and the use of microsurgery.
If there is good sperm in the vas deferens at the time of reversal and the vas deferens can be reconstructed, there is a 95 percent chance man will have sperm return to the semen afterwards.
The possible success of initiating a pregnancy following a vasectomy reversal involves female factors as well. Studies have indicated that if a woman is under the age of 40, there is about a 60 percent chance for pregnancy. If the woman is over the age of 40, the percentage drops to 15 percent pregnancy rate.
If a couple needs to undergo IVF anyway, sperm retrieval may be the more preferred method.
If a couple is wishing for more than one child, then vasectomy reversal may be the most cost effective means providing there are no additional female fertility factors.