An increasing number of men are presenting for treatment who have had a vasectomy.
A vasectomy reversal is, a surgical procedure that restores the flow of sperm through the vas deferens. It is usually performed by an experienced microsurgeon using specialized instruments, including an operating microscope. The sutures used in vasectomy reversal are finer than human hair.
There are two types of vasectomy reversals: vasovasostomy and vasoepididymostomy. A vasovasostomy is the operation most frequently performed for vasectomy reversal. It entails stitching the cut ends of the vas deferens together.
Success rates vary. Factors affecting success rates post vasectomy are:
- The age of the man
- The presence of antisperm antibodies
- Time elapsed since the vasectomy
- The age of the woman
The option of reversal of vasectomy is not one that we would encourage. Depending on the ‘definition’ of a successful reversal, many patients will have sperm in the ejaculate after a reversal of vasectomy. HOWEVER, for the purpose of viability, a vast majority of ejaculates after a reversal will not result in adequate quality of sperm production for natural conception to occur.
Sperm aspiration followed by ICSI would be the ideal treatment option in this instance.