Vasectomy reversal is the surgical reconstruction of the male reproductive system after a vasectomy.
It’s estimated that 2-6% of patients who undergo a vasectomy will pursue a reversal. Success rates vary significantly and depend on the unique situation of each patient and his partner, including the type of reconstruction needed.
During your consultation with Dr. Matson, he will help you consider the range of personal factors that will inform your treatment plan in pursuit of having a child.
There are two types of advanced microsurgical procedures that may be used to return the flow of sperm to the ejaculate. Dr. Matson has mastered both.
Simply put, a vasovasostomy (VV) surgically rejoins the ends of the vas deferens, while a vasoepididymostomy (VE) connects the vas deferens to a different, tiny tube in the epididymis.
Let’s get technical.
In a vasovasostomy, the scars that cap the vas deferens are surgically removed and the two ends are rejoined. The reconnection is performed in multiple layers using a surgical microscope.
It’s a technically difficult surgery that is performed in a hospital and usually takes about 4 hours. It requires general anesthesia for the patent’s comfort and immobilization. (Any movement at all is disruptive to this precise procedure.)
Click to see a magnified photo from a recent procedure, showing the first of three layers of microsutures.
Sperm flow is successfully returned in roughly 75-95% of patients. Pregnancy rates trail behind success rates by 20-40%. The success rate of any VV depends on many factors including:
- The amount of time since the vasectomy
- The age of the intended female partner
- Findings that are not known until the surgery begins.
All vasectomy reversal procedures begin with a VV intended, however, the extent of scarring may call for a VE to be performed instead. Here’s why: As time goes by after a vasectomy, scarring can occur in the delicate tubes upstream and closer to the testicle. This makes a VV unlikely to succeed. In such cases, in order to tap into the source of sperm, the fresh end of the vas deferens is connected upstream to the tiny tube of the epididymis.
This is a very challenging reconnection using only two micro-sutures to attach the lining of the dissimilar tubes together. The tiny size of the epididymal tube (150-250 microns or to 2-4 times the width of a human hair) makes the success rate lower than a typical VV.
Sperm extraction is another possible route to conceiving.
If upon examining your specific situation, you and your partner decide that a vasectomy reversal is not the right choice for you, there are several methods for surgically extracting sperm from the testicle for use in In-Vitro Fertilization (IVF).
All options should be carefully considered by both partners as the choice will not only impact success rates, but also carry financial, medical and lifestyle implications.
These choices are personal and there is no right answer.
Again, you are encouraged to reach out and schedule a consultation so Dr. Matson can help you make the best possible choice for your situation and needs.