Vasectomy is a safe and effective long-term contraceptive option. By the age of 40, about 25% of Australian men have undergone a vasectomy, and there are about 30,000 procedures performed annually.
It is estimated that about 1.5% of vasectomies are surgically reversed, but the long-term fertility potential of these men isn’t always restored. A pregnancy occurs after surgery in around only 50% of cases.
Vasectomy reversal surgery
Vasectomy involves cutting and removing a section of the vas deferens, the tube that carries sperm from the testicle to the urethra at the base of the bladder. To allow for a possible later reversal, a sufficient length of the tube should be left in place.
Microsurgical reversal involves joining of the two ends of the vas (vasovasostomy). Or, if an obstruction has occurred in the epididymis (the coiled channel that leads from the testicles), we would need to join the vas to a section of the epididymis (vasoepididymostomy).
The chances of success
While the reappearance of sperm in the ejaculate can prove a successful reversal, the only important marker of success is achieving a pregnancy in the years following surgery.
The chances of success depend largely on the amount of time that has elapsed since the original vasectomy. In a US study, the pregnancy rate over the two years after surgery in men with less than three years between vasectomy and reversal was 76%, while the pregnancy rate was only 30% when the vasectomy had been performed 11 or more years earlier. Of course, the skill and experience of the surgeon also affects the success rate.
Sperm microinjection (ICSI)
For an increasing number of couples experiencing vasectomy-related infertility, the use of sperm retrieval and single sperm microinjection (also known as intracytoplasmic sperm injection, or ICSI) is an alternative way to achieve a pregnancy. With this method, sperm are obtained by needle directly from the testicles or epididymis, and the success rates are similar to those of other types of IVF.
If you are considering vasectomy reversal, you will want to think carefully about the relative risks, benefits and costs of surgical reversal as opposed to sperm microinjection.
Contact us to find out more about male fertility treatments.