Have you been thinking about adding to your family again? Do you miss the pitter-patter of little feet? Well, if you have had a vasectomy you may believe that you will never be able to welcome another child into your family. However, with recent advances in microsurgical vasectomy reversal techniques, even men who have undergone vasectomies can have a chance to produce another child. Known as vasectomy reversal, this type of surgery can make it possible for you to conceive a child with your partner once again.
What is a Vasectomy Reversal?
A vasectomy reversal is a surgical procedure used to reverse the effects of a vasectomy. Vasectomies are commonly performed in order to pernmanently induce male infertility. They are often used in order to provide a couple with a safe and effective form of birth control. During a vasectomy, the tube which carries sperm from a man's testicle to his penis (the vas deferens) is cut. Vasectomy reversals work to reattach the severed vas deferens, allowing sperm to once again travel to the penis.
How Common are Vasectomy Reversals?
Vasectomy reversals are actually becoming quite common, particularly in the United States. In fact, 5% to 10% of all men who undergo vasectomies will eventually choose to have a vasectomy reversal. This amounts to about 60,000 men every year. Vasectomy reversals are often performed:
- after a loss of a child
- after remarriage
- when a couple decides, unexpectedly, to continue adding to their family
Types of Vasectomy Reversals
There are actually two different types of vasectomy reversals. Both of these procedures are performed using microsurgical vasectomy reversal techniques. This means that the surgeon performing the reversal will use a high-powered microscope in order to make delicate incisions and sutures.
In order to determine what type of vasectomy reversal you will have, your health care provider must first determine whether you have any sperm present in your vas deferens. Fluid from your vas deferens will be removed while you are under sedation. This fluid will then be microscopically examined for the presence of sperm. If sperm is found, you will have an vasovasostomy. If sperm is not found, you will receive an epididymostomy:
The vasovasostomy reversal is the most common type of vasectomy reversal. It is performed if sperm are found to be present within the vas deferens. During the vasovasostomy, the severed ends of the vas deferens are reconnected. Your surgeon will make small incisions along the sides of your scrotum, exposing your vas deferens. Any scar tissue will be removed from the ends of these tubes and the two ends will then be connected using tiny, dissolvable stitches.
The epididymostomy reversal is a much more complex surgical procedure. It is used when no sperm are found within the fluid in the vas deferens, suggesting a blockage. During this procedure, the top end of the vas deferens is connected directly to the epididymis, the tube where sperm are stored and matured. Your surgeon will make a small incision in your scrotum, exposing your vas deferens and epididymis. Using dissolvable stitches, your surgeon will then attach your vas deferens to the epididymis, avoiding any blockages.
Recovery From Vasectomy Reversal
Recovery from a vasectomy reversal is relatively short. You will need to stay off your feet for a couple of days. You may experience pain on a level similar to that incurred after your original vasectomy. To help manage your discomfort, your health care provider will prescribe you pain relievers. You will also need to wear a supportive cup for about six weeks after the surgery. Avoid heavy exercise or activity for at least four weeks. Abstain from sexual intercourse or ejaculation for at least four weeks, too, to ensure that the vas deferens has a chance to heal.
Are Vasectomy Reversals Effective?
The success of a vasectomy reversal relies on a variety of different factors. Specifically, success rates are affected by:
- the type of vasectomy reversal performed
- the skill of the surgeon performing the surgery
- the length of time elapsed between the original vasectomy and the reversal procedure
The vasovasostomy reversal tends to be much more successful for most patients. Between 75% and 97% of men who have a vasovasostomy, see their sperm return to their ejaculate within three months. Between 40% and 60% of these men achieve a pregnancy within 2 years.
Epididymostomy results are less successful, however, they are still good. Between 60% and 80% of men experience a return of sperm in their ejaculate, but this can take up to 15 months. Pregnancy rates are also lower ' they are generally around 30% to 40%.
Generally speaking, the less time that has elapsed between your vasectomy and your reversal, the better. Men who have reversals within three years of their original vasectomy are much more likely to have sperm mix with their ejaculate again. Those who wait longer than 10 years to have a reversal are much less likely to have their sperm return.
Costs and Alternatives to Vasectomy Reversal
Unfortunately, the cost of a vasectomy reversal tends to be quite high and these surgeries aren't generally covered by insurance. Because they require advanced microsurgical techniques and highly skilled surgeons, many reversals can cost upwards of $10,000. This can make vasectomy reversal impossible for many couples. However, couples looking to get pregnant can opt for an alternative to vasectomy reversal.
- Surgical Sperm Retrieval: A man's sperm can be removed from the testicles, vas deferens, or epididymis and used in various infertility treatments. Using a needle, sperm can be aspirated from the genitals, and stored for later use.
- Sperm Donation: Donor sperm can be used in fertility treatments in order to achieve a pregnancy. This can often be a much less expensive option.
- Adoption: Though often a challenging journey, adoption is a non-surgical way to add to your family.