Maybe you had a vasectomy and are now regretting it. Or you purposefully used it as a temporary form of male birth control. In any case, this is what you need to know before going back under the knife.
The Success Rate Is Improving
Advances in microsurgery have made vasectomy reversal much less complicated than when it was first performed in 1971. In fact, one recent study of 1,469 men who underwent a vasovasostomy at five different institutions found that 86% of them had some level of patency (active sperm in their semen) in a postoperative analysis.
How Long You Wait Between Procedures Matters
The amount of time between a vasectomy and its reversal plays a huge part in how successful the procedure (and resulting pregnancy) will be. If you get a reversal within three years of your vasectomy, your chances for patency are 97% and pregnancy are 73%, respectively. Wait 15 years, however, and the percentages drop to 71% and 30%.
Vasectomy Reversal Isn’t Cheap
Whereas a vasectomy can take as little as 10 minutes, a vasovasostomy typically requires two to three hours to perform. It’s done under general anesthesia in an operating room and, as a result, the costs are much higher ⏤ ranging anywhere from $2,000 to $25,000. Worse, insurance companies usually don’t cover it.
You Won’t Be Fertile Immediately
After a vasovasostomy, motile sperm often appears in 2 to 3 months. Most men stay fertile indefinitely after the procedure. Between 50% and 80% of men who have had a vasectomy develop anti-sperm antibodies that impair their little guys from moving around. As a result, they experience a lower rate of successful future pregnancies. If the antibodies are found in your sperm sample, your doctor will likely put you on a steroid while you’re trying to conceive to increase sperm mobility. Scar tissue from the initial procedure can also block the vas deferens, which is the tube initially cut in the vasectomy. This only occurs in 3% to 10% of all men who get the procedure. But when it does occur, it may require additional surgery to properly clear the vas deferens.
There Can Be Side Effects Of Vasovasostomy
Complications — including postoperative hematomas, infections, and bleeding — occur in less than 5% of men and are easily remedied without long-term effects. The big takeaway is that “reversing a vasectomy should not cause issues. It should not affect feeling, libido, erections,” says Robert Mordkin, M.D., chief of urology and director of robotic surgery at Virginia Hospital Center.
You May Need A More Complicated Reversal Procedure
If sperm is present in the vas deferens, doctors will use tiny sutures to rejoin the 2 ends. This vasovasostomy procedure procedure lasts for about an hour. Done and done. But if the vas is dry, a buildup of pressure probably caused a blockage in the epididymis, a tightly coiled tube that connects the testes to the vas. In a procedure called a vasoepididymostomy, doctors will connect the upper portion of the vas directly to a lower portion of the epididymis. Vasoepididymostomy is a more complicated, longer operation than a vasovasostomy (it lasts anywhere from 2.5 to 4 hours) and has a slightly lower success rate. If you have a vasoepididymostomy, it can take up to a year for your swimmers to start doing laps again.
There Are Other Options Than Vasectomy Reversal
If you’re serious about having another child but don’t want to undergo a vasectomy reversal, you could always try in vitro. Your body doesn’t stop producing sperm after your vasectomy, and it can be withdrawn directly from your testicles in an outpatient procedure that causes minimal issues, save one: It’s very expensive and not usually covered by insurance. In fact, the latest studies show that it costs more than double that of a vasovasostomy with a 19% lower success rate of successful future pregnancy.
