Microsurgical Vasectomy Reversal
Over 500,000 vasectomies are performed each year in the United States. About 3 per 1,000 of these men request a reversal. The success of vasectomy reversal is dependent on two main factors: The amount of time since the vasectomy and the technique of the surgeon. A microsurgical technique is crucial to success.
Our Success Rates
The vasectomy reversal surgeons at Arizona Urology Specialists have success rates between 90% and 95% for all men who have a reversal no matter how long it’s been since their vasectomy. This is due to newer techniques and expertise in complex vasectomy reversal reconstruction.
In the past, studies evaluating microsurgical vasectomy reversal techniques have demonstrated decreased success rates at the interval between vasectomy and vasectomy reversal rates increases. The most highly regarded study involved over 1,400 men at five different centers. This demonstrated that among men undergoing microsurgical reversals within 3 years of their vasectomy, 97% will have sperm return to their semen, and 76% will initiate a pregnancy. At 3 to 8 years, 88% of men will have sperm return to their semen, and 53% will initiate a pregnancy. From 9 to 14 years, 79% have sperm and 44% get pregnant. Finally, among men undergoing vasectomy reversal 15 years or more after their vasectomy, 71% have sperm return to their ejaculate and 30% initiate a pregnancy. Current studies, however, demonstrate significantly higher success.
Vasectomy Reversal Vs. In Vitro Fertilization – Comparing Success Rates
The success rates with vasectomy reversal compare very favorably to in vitro fertilization pregnancy rates, which are typically around 40%. In addition, vasectomy reversal is less expensive than in vitro fertilization and eliminates female complications from hormonal manipulations that occur during in vitro fertilization. Finally, the twin or triplet birth rate (around 40% with in vitro fertilization) is not increased with vasectomy reversal.
Microsurgical Vasectomy Reversal Techniques
Vasectomy reversal is performed as an outpatient surgical procedure. The surgeon performs the procedure using an operative microscope and extremely small sutures (9-0 and 10-0). This allows a watertight connection between the two previously cut ends of the vas deferens. This procedure usually takes about 3-4 hours.
During the procedure, fluid from the vas deferens is examined under the microscope to confirm that no additional blockages are present. When an additional blockage is present, it usually occurs in the epididymis. The epididymis is an extremely small and delicate tube that transports sperm from the testicle to the vas deferens. If the epididymis is blocked, the surgeon connects the vas directly to the unblocked portion of the epididymis, thereby bypassing the blockage. This procedure requires additional operative time and microsurgical skills, but success rates still remain around 90% when the vas is connected to the epididymis.
Although microsurgical vasectomy reversal success rates are very high, occasionally a reversal is not successful. In such cases, it is helpful to have preserved sperm available. Dr. James Daitch and Dr. Robert Shapiro both possess honed microsurgical skills, and work closely with embryologists located in central Phoenix, Scottsdale, the West Valley, and East Valley. Sperm obtained during the vasectomy reversal can be preserved by the embryologist and used in the future, if necessary.