A vasectomy is considered a permanent method of birth control. A vasectomy is a minor surgical procedure in which the sperm duct, or vas deferens, is cut in order to achieve sterility. Vasectomy reversal (vasovasostomy) restores fertility by reconnecting the ends of the severed vas deferens, which is located in each side of the scrotum, or by connecting the vas deferens to the epididymis, the small organ on the back of the testis where sperm matures. These procedures restore the passage for sperm to be ejaculated out the urethra with microsurgical technique.There are many reasons to reverse a vasectomy like remarriage following a divorce or having a change of heart or starting a family over after the loss of a wife or child. Regardless of your reason, there are now advanced methods to restore your fertility. Vasectomy reversal is usually an outpatient procedure requiring fine microsurgical skills and a particular training. Spinal or general anesthesia is commonly used to ensure that you stay completely still during the surgery.The chances of vasectomy reversal success depend on how much time has passed between the vasectomy and the reversal. Over time, additional blockages can form, and some men develop antibodies to their own sperm.The surgery is more complicated and takes more time when blockage between the vas deferens and the epididymis requires correction (vaso-epididymostomy).
Vasectomy reversal usually takes 2 hours, followed by a few more hours for recovery from the anesthetic. The microsurgical approach is recommended and uses a high-powered microscope to magnify structures from five to 40 times their actual size. Use of an operating microscope provides better results, as it allows the surgeon to manipulate stitches smaller in diameter than an eyelash to join the ends of the vas. When microsurgery is used, vasovasostomy results in return of sperm to the semen in more than 90 percent of patients.
We use special attention to the postoperative pain so It’s usually mild, comfortable and well tolerated. We suggest rest for 2-3 days and You should be able to resume normal activities, including sex, within 3 weeks. You will be advised to wear a jockstrap for support for several weeks.
Chances of a successful vasectomy reversal decline over time.
The physician will request a semen analysis every two to three months after surgery until your sperm count either stabilizes or pregnancy occurs. Unless a pregnancy occurs, a sperm count is the only way to determine surgical success. While sperm generally appear in the semen within a few months after a vasovasostomy, it may take from three to 15 months to appear after a vasoepididymostomy.
Reversals are more successful during the first 10 years after vasectomy with the greatest chance of success being within 3 years of the vasectomy.
In general, vasectomy reversal leads to overall pregnancy rates of greater than 50% but leads to pregnancy only about 30% of the time if the reversal is done 10 years after vasectomy
It takes on average one year to achieve a pregnancy after a vasectomy reversal. Some pregnancies occur in the first few months after the reversal procedure, while others do not occur until several years later.
Before a vasectomy reversal is done, your doctor will want to confirm that you were fertile before your vasectomy.
You can have tests to see whether you have sperm antibodies in your semen before and after vasectomy reversal. If there are sperm antibodies in your semen after surgery, your partner is unlikely to become pregnant. In such a case, you may wish to try in vitro fertilization with intracytoplasmic sperm injection.