1 https://www.fertstert.org/article/S0015-0282(04)01062-3/fulltext

FAQ

Vasectomy Reversal Success Rates

The answer to the question, “Will it work?” is most likely to be yes. To put it briefly, the success rate for vasectomy reversals is high, with the restoration of sperm in up to 90% of men and the majority of couples going on to achieve pregnancy. Key factors in this chance of success are the time between vasectomy and reversal - less than 10 years is best - and the age of the female partner - less than 35 years gives you a better chance. The skill and experience of the Specialist is also a vital element to consider.

Getting down to specifics, doctors assess the success of a vasectomy reversal in two ways:
  1. They look for the practical success of your surgery by checking that the procedure has resulted in the return of sperm. This is known as patency. In most cases, sperm returns gradually. Six weeks post-surgery, up to 50% of men will have sperm present, rising up to 90% by 12 weeks post-surgery.
    Men who have a shorter gap between their vasectomy and reversal have higher outcomes than those who have a gap of more than 10 years. However, studies show that even in men who had a vasectomy more than 20 years ago, many of them will still see a return of sperm after the reversal.
  2. A doctor assesses the vasectomy success rate is functional success - ie the patient getting their partner pregnant. The overall postoperative conception rate is quite high - between 50% to 80%.
That’s the statistic but how do you figure out your own personal chance of getting your partner pregnant after a vasectomy reversal? It’s most dependent on two factors; the amount of time since you had the vasectomy and your partner’s age.

That’s because the single most important factor influencing pregnancy rates and the birth of a baby following vasectomy reversal is female age. The younger your partner, the higher the chance of successful pregnancy.

Similarly, the shorter the time since the vasectomy, the higher the chance of a successful reversal. This is because over time, back pressure on the testis following a vasectomy can cause damage to sperm production. Additionally, the very fine tubule (epididymis) just next to the testis can be damaged by this pressure and can break open and then regrow with scars causing a second blockage very close to the testis.

Finally, the surgical technique used for the procedure and the skill and experience of the Specialist conducting the operation are both highly important. The best results are obtained when you visit a Specialist trained in microsurgical techniques. Genea Fertility Specialist Dr Derek Lok conducts highly specialised microsurgical vasectomy reversal through small scrotal incisions, resulting in rapid recovery.

A study conducted by the American Society for Reproductive Medicine’s Vasovasostomy Study Group and published in the Fertility and Sterility Journal1 found that in 1,247 patients the patency and pregnancy rates were 97% and 76% if the obstructive interval was less than three years, 88% and 53% if the interval was three to eight years, 79% and 44% if nine to 14 years, and 71% and 30% if 15 years or longer.

Vasectomy Reversal Procedure

These days, preoperative testing for men planning a vasectomy reversal is unnecessary except for routine preoperative tests that may be required due to other medical conditions. While testing for anti-sperm antibodies used to be common, we now know that this test does not effectively predict the outcome of the operation. As a result, anti-sperm antibody testing before the procedure has largely been abandoned by fertility microsurgeons.

Vasectomy reversals are performed under general anaesthetic, through one or two small incisions in the scrotum above the testes. These incisions are similar and often not bigger than your original vasectomy incision. Dr Lok uses advanced microsurgical techniques to identify the two ends of the cut vas deferens and prepare them for reattachment. Once this preparation is complete, the two ends of the vas deferens are sewn together using microscopic sutures. This first series of sutures brings the ends together and establishes patency. A second layer of sutures is then completed to add support and stability to the site of the join.

Once the Specialist finishes this microsurgery, the scrotum is also closed in two layers, the first a continuous suture to bring the tissues together and the second joining the skin edges using a very fine stitch just beneath the skin. The incision sites are then covered in surgical dressing. This particular method of vasectomy reversal is known as vaso-vasostomy.

Vasectomy Reversal Recovery

So will it hurt? As a rule, recovery from a vasectomy reversal is generally quick with almost all patients leaving hospital a few hours after the procedure. Once home, you should plan to rest. While there is usually some discomfort at the operation site, most men can undertake normal, non-strenuous, day-to-day activities within the first week after their vasectomy reversal operation. That said, excessive movement and exercise should be avoided for two to four weeks as this may cause post-operative bleeding and delay recovery.

Approximately 10% of men will find their recovery progresses more slowly. Almost all patients will return to normal physical activities within one month.

Sex should be avoided for two to four weeks after your vasectomy reversal, depending on your recovery.

Most men can return to work within seven to 10 days of the vasectomy reversal procedure. Those who work in relatively sedentary occupations can return to work earlier and those with strenuous jobs may need to take longer leave.

Cost of Vasectomy Reversal

The total cost of a vasectomy reversal includes:
 
  • Surgical fees (covering the surgical procedure and pre and post-operative consultations);
  • Anaesthetist’s fee;
  • Hospital fee (covering the operating theatre and hospital accommodation).
The final cost of each of these elements varies depending on whether or not you have private health insurance as well as which day surgery or hospital you select for your operation.
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