Vasectomy reversal info and expirience from a person who has actually done one

 

This is an informative, non-professional website about vasectomy reversal which will try to give you answers on frequently asked questions about it. My name is Alen Rizlic, I'm from Croatia, and I was on reversal vasectomy surgery about a year ago (after my vasectomy in 2001) in the United Stats. You probably ask yourself, what was my motive to do it? Well, nothing special, I just didn't feel right beeing infertile! About 1-5 men out of 100 who have had a vasectomy will decide to undergo a reversal.
Let's start with basics - men reproductive anatomy. This picture ilustrates it:

The testicle makes sperm that is stored in the epididymis. During ejaculation (the process of ejecting semen from the penis, usually accompanied by orgasm as a result of sexual stimulation), sperm are transported from the epididymis and travel down the vas deferens into the prostate. Prostate fluids and seminal vesicles mix with the sperm in the ejaculatory and make the ejaculate (semen).

Vasectomy

A vasectomy is a surgical procedure that men take to make themselves infertile. The procedure blocks the vas deferens and prevents sperm from flowing to the prostate. Obstruction of the vas deferens is usually accomplished by removing a small segment of it and placing a suture or small metal clip on the end of the vas.

Vasectomy reversal

And after a time, some men decide to restore their fertility by means of a vasectomy reversal, an operation that is, unlike vasectomy, very complicated and long-lasting. It requires high expertise from microsurgeons that perform the operation using a microscope with help of which they can use fine, delicate instruments.
WARNING! Less precise procedures are performed by some doctors because they take less time and do not require as much surgical skill.
The most common way of reconnecting the "tubes" (the vas deferens) that are cut during a vasectomy is by sewing them together using sutures that are finer than human hair. That procedure is called vasovasostomy. The vas deferens is cut above and below the site of the previous vasectomy, and the two ends are precisely aligned. Difficulty of the procedure is best shown through the information that those "tubes" are in diameter about the width of a strand of spaghetti, and the channels that conduct sperm are barely visible to the naked eye. That small scale makes the surgery very difficult. Furthermore, over time (from the date of vasectomy) the pressure in testicles, where the sperm is being produced, grows, because the sperm cannot be released. That can cause epididymis to leak and scar creating a blockage that prevents sperm from getting out. The fluid that comes out of the vas deferens (after it is incised by the microsurgeon to check if the path of the sperm is blocked) can be examined with a microscope in the operating room. The fluid can be thick and not contain sperm.

In that case (about 25% of men), vasoepididymostomy is performed to bypass the blockage, in which the vas is connected to the epididymis at the level above the blockage.

 

Recovery from vasectomy reversal

There will be swelling and bruising of the scrotum, which typically doubles in size but goes back to normal within one week. Pain pills can be provided if the pain is very strong, but most patients do not use more than a few pills in the first few days.
In order to prevent to prevent damage to the anastomosis, you shouldn't have sex about a month after the surgery, and that is also a period in which the sperm can appear again.

Reversal vasectomy success rates

Success of the operation is defined as:
1. the return of sperm cells to the ejaculate
2. pregnancy
The following table shows succes rates for standard vasectomy reversal - vasovasostomy:

 

As you can see, the chance of having sperm in the ejaculate and the chance of pregnancy deteriorates with increasing time.
The main reasons why "surgical success" rates are higher than pregnancy rates lie in these facts:
1. Surgery restores sperm cells to the semen but the sperm are weak or low in number.
2. Good numbers of strong sperm are found after surgery but "antibodies" that attack sperm are present.

BUT! The sperm produced from the resulting vasectomy reversal can also be used with additional assisted reproductive techniques to significantly increase the chances of pregnancy.
FACT! If you have expected higher pregnancy rates after undergoing vasectomy reversal, just remember that without it, your chances would be O!

Succes rate of vasoepididymostomy is about 75%, which is significantly higher than the 10% chances of vasovasostomy if the sperm path is blocked.
BUT! The fluid may be thick but still contain sperm or sperm fragments. On the other hand, the fluid may be thin but may not contain sperm or sperm fragments. In these cases, it is impossible to know if the epididymis is blocked or not. In most cases, vasovasostomy is then performed.

Reversal vasectomy cost varies from one place to another, from about 5000$ to 10000$.

Even free vasectomy reversal is possible (through medical insurance), but it most cases it isn't.

I had no problems with my vasectomy reversal and I would reccomend people that are asking themselves if they should do it not to fear and to trust the doctors that are professionals in that field! But before you do that, make sure you've done enough research to find the right specialist.