It might have seemed like a good idea at the time...but if the man in your life was surgically sterilized and you’d now like to be parents, here’s what you need to know.
Surgical sterilization is the most commonly-relied on method of contraception in the U.S. And the vast majority of people who opt for the surgery are satisfied with their decision. But sometimes—for a variety of reasons—men (and women) who’ve had sterilization surgery decide they want to be parents again (surgical sterilization is rarely performed on people who haven’t had children).
According to a study done at Columbia-Presbyterian Medical Center, approximately 500,000 men have vasectomies each year in the United States, and while that number remains roughly the same from year to year, the number of men requesting vasectomy reversal has increased. The study estimates that about 1 percent of men who have had a vasectomy will eventually desire a reversal.
The good news is that thanks to advances in microsurgery the chances are better than ever that reversal will be successful.
“Basically, a vasectomy interrupts the flow of sperm through the vas deferens, and a vasectomy reversal reconnects the obstructed pathway,” explains Neil Baum, MD, a urologist, and clinical associate professor at Tulane Medical School in New Orleans, Louisiana. “A vasectomy reversal is an outpatient procedure. We can do a reversal on Friday, and a man can be back at work on Monday.”
Thanks to new microsurgical techniques, surgeons now consider it rare that a vasectomy cannot be reversed. Between 85 and 97 percent of men who opt for reversal surgery have a reoccurrence of sperm—meaning sperm is present in the ejaculate again—and approximately 50 percent of couples will ultimately become pregnant (depending on the woman’s fertility as well).
There are two types of vasectomy reversal: a vasovasostomy, in which the surgeon stitches the cut ends of the vas deferens, and a vasoepididymostomy, which entails connecting the vas deferens directly to the epididymis. Both these procedures require the expertise of an experienced microsurgeon.
“Even though the procedure itself and the recovery period are fairly short, the average length of time for sperm recurrence is from 90 to 180 days,” said Dr. Baum. “This depends on the amount of time passed between vasectomy and reversal. Couples should not expect to get pregnant right away.” The average length of time between vasectomy reversal and pregnancy is 12 months.
What You Need to Know…
For vasectomy reversal, men should choose board-certified doctors. The American Board of Medical Specialties (ABMS) allows patients to verify board certification status and location. Go to www.abms.org to access a doctor’s status. A vasectomy reversal requires the expertise of a urologist with microsurgical experience.
Most health insurance policies cover the procedure. A vasectomy reversal can cost from $5,000 to $15,000. If your company has a Flex Spending plan, you might be able to use that account to help pay for the surgery.
A Reversal Success Story
When Eileen Farmer got together with her husband, Brad, he told her he’d had a vasectomy when he was 18 years old, because he knew he never wanted children. “I was okay with that,” says Eileen, “because I thought I never wanted children, either.” Brad had been the oldest of five, and his mother had run a daycare center. “He’d already done so much babysitting, he thought he’d had enough,” explains Eileen. “And I was an only child, and loved it. Not growing up with other kids, I didn’t think I’d miss it.”
Then, after the couple had been together for more than a dozen years, and Eileen was turning 35, she began to change her mind. “Something maternal just kicked in with me. Brad is a wonderful man;, and I thought we’d be really good parents together.”
Eileen talked to her huband, trying not to pressure him. “But while he was thinking about it, I started researching vasectomy reversal. By the time he said he wanted a child, too, I knew which doctor he should go to.”
In December, 2001, Brad had the surgery. His first post-operative semen analysis was encouraging. “We thought getting pregnant would be a breeze,” Eileen remembers. “But then a year went by and I still wasn’t pregnant.” Another semen analysis revealed a much lower count. (The change may have been due to post-operative scarring.)
Eileen and Brad were told their only hope of getting pregnant would be a high-tech procedure like in vitro fertilization. “We thought about it,” says Eileen, “but our insurance didn’t cover it, and we’d already spent so much on the surgery. We finally decided it just wasn’t meant to be, and we gave up.”
Later that year, Eileen noticed her breasts were sore. “When I mentioned it to Brad, he asked when my last period was. I couldn’t remember!” A home testing kit revealed that Eileen was indeed pregnant.
After a routine, healthy pregnancy, Eileen gave birth to her daughter, Avery Elizabeth Vaughn, on July 18, 2004. “I was 38 when Avery was born, and my husband was 40. It’s really a miracle.”
A version of this article was originally published in the Spring 2005 issue of Conceive Magazine.
Related Topics: Male Factor Infertility; Male Fertility; Your Relationship and Trying to Conceive