diagnosis guide
If you’ve just received a medical diagnosis, or you’re concerned that something in your present or past health history might be jeopardizing your fertility, check here for quick info on common medical conditions and how they can affect conception and pregnancy.
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Vasectomy (and Reversal)
What It Is
Vasectomy a simple, safe, and highly effective surgical sterilization procedure for men. It’s usually performed on an outpatient basis, and has a short recovery period. The procedure has a failure rate of less than 1 percent. During a vasectomy, the vas deferens—the tubes that sperm travel through before ejaculation—are tied, cut, clipped, or sealed to prevent the release of sperm. A vasectomy is not effective right away. There may still be sperm in the semen for up to three months after the surgery is performed, so men should use back-up contraception for up to 12 weeks.
Who Gets It
Men who do not want to get their partners pregnant or become fathers in the future.
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.
Treatment (Reversal)
Vasectomy reversal surgery aims to reconnect the obstructed sperm pathway. 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. 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 (www.abms.org to check a doctor’s status). A vasectomy reversal requires the expertise of a urologist with microsurgical experience.
Pregnancy Prognosis
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). But, couples should not expect to get pregnant right away; the average length of time between vasectomy reversal and pregnancy is 12 months. Several factors influence the success rate of the reversal: The longer the interval between the vasectomy and the reversal procedure, the lower the chance of success. So, don’t delay and use a urologist who specializes in male infertility treatment. For couples who are unable to get pregnant naturally after vasectomy reversal, high-tech procedures like ICSI (intracytoplasmic sperm injection, in which a single sperm can be manipulated to fertilize an egg) can help.
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