03 Oct Vasectomy Reversal
Vasectomy is a common method of contraception worldwide. Approximately, 5% of men choose to have a vasectomy reversal afterward. Vasectomy reversal is surgery performed to undo a previously vasectomy for the purposes of reversing male infertility. It involves connecting each tube (vas deferens) that carries sperm from a testicle into the semen. This allows sperm to flow into the semen so that the male is able to impregnate the female again.
Sperm is produced in the testicles and then travel through efferent tubules to reach epididymis where they are stored and mature to a form that can swim and fertilize eggs. Testicular sperm is not capable of fertilizing eggs naturally. From the epididymis, a muscular tube called the vas deferens carries the sperm to the urethra, from where they are ejaculated out. A vasectomy involves obstructing the sperm flow within the vas deferens. After a vasectomy, the testes continue to make sperm, but they are immature and cannot travel further, and are eventually reabsorbed by the body.
- Bleeding within the scrotum: This can cause hematoma and lead to painful swelling. Avoid early activity post-surgery and blood thinners, such as aspirin to prevent them.
- Infections: They are a risk with any surgery and can be avoided with antibiotic coverage.
- Chronic pain: This is very uncommon.
- Hydrocele: Fluid buildup in the scrotum may occur, which requires draining.
- Injury to the arteries or nerves in the scrotum: These are rare.
What happens before the procedure?
Your doctor will perform tests before a vasectomy reversal is performed to confirm that you were fertile before your vasectomy. This includes assaying sperm antibodies in your semen before and after vasectomy reversal. If there are sperm antibodies in your semen after surgery, it is unlikely that you are able to have pregnancy.
What happens after the procedure?
Vasectomy reversal is a relatively short procedure (2 to 4 hours). It takes a few more hours to recover from the effect of the anesthetic, and you can go home the same day. You can expect to resume normal activities in a few days and perform sex within 3 weeks.
Success rates with vasectomy reversal typically range from 40 percent to 90 percent. The most important factors that determine the success rate include time since a vasectomy, partner age, and surgeon experience and training. Not all reversals lead to resumed fertility, and the longer it’s been since the vasectomy, the harder it is for the reversal to work. Your best chance of success at vasectomy reversal is in the first 10 years after vasectomy. This means you will have a greater than 50% chance at pregnancy, with the highest rate in the first 3 years.
If vasectomy reversal fails, the couple will need to resort to in vitro fertilization methods, such as intracytoplasmic sperm injection (ICSI), if they wish to conceive.