While it may be a complicated procedure, microsurgical vasectomy reversal can be performed on men who wish for natural pregnancy.
There are also alternative procedures to extract sperm directly from the testicles, which will then be used in fertility treatments such as IVF.
snip, fix, repeat
Microsurgical Vasectomy Reversal
Vasectomy reversal surgery, also called vaso-vasostomy, is performed in men who have been previously sterilised, with a view to achieving a natural pregnancy. The tube that carries the sperm from the testicle into the body and the ejaculate, is called the vas deferens. These tubes are joined together under a surgical microscope, using very thin sutures.
Who should consider a vasectomy reversal?
Men who want to father children but have previously been sterilised. It is important to consult with your surgeon beforehand, as many factors play a role in achieving a pregnancy. Your previous fertility history, your partner’s age and the time since you had your vasectomy are some important factors.
What are the alternatives?
Sperm can be obtained directly from the testicle with a biopsy or using the micro-TESE procedure. The sperm will need to be used in fertility treatments (assisted reproduction) such as artificial insemination or in vitro fertilisation (IVF).
how successful is it?
90% of cases
The success rate is looked at in terms of patency rates (the surgeons’ ability to join the tubes together again) and is reflected by the presence of sperm in the ejaculate after the procedure. These rates are typically quite high, up to
The more important outcome is pregnancy rate. Getting sperm into the ejaculate is just the first step. The quality of the sperm and the many female factors (age, egg quality, previous pregnancies, etc) all play a role. The pregnancy rates are therefore much lower than the patency rates.
What are the risks?
Risks of this surgery include testicular and scrotal discomfort and swelling. Severe pain, bleeding and infection are uncommon. Chronic testicular pain is very rare after a vasectomy reversal, in fact, vasectomy reversal is sometimes performed to treat chronic testicle pain. There is a chance that the procedure is not successful in getting sperm into the ejaculate.
What happens during the procedure?
Under anaesthesia, two small incisions are made on either side of the scrotum, and the vas deferens exposed. The surgeon trims the edges and joins the tubes together using very fine sutures. Sometimes, fluid from the testicle is sent to a specialist embryologist at the fertility clinic, who will look for the presence of sperm. If no sperm is found, the surgeon may have to perform a slightly different procedure, where the vas deferens is joined directly to the epididymis. It is also possible, during the same procedure, to extract sperm directly from the testicle. Your sperm will then be frozen by the embryologist for future reproductive treatment, such as in-vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI).
what to do next
Check out the FAQ page for what you can expect before and immediately after surgery. Also, what not to do when you get home.