Vasectomy Reversal
From LoveToKnow Pregnancy
Reversing a Vasectomy
If a man has had a vasectomy and later decides that he would like to father a child, he may choose to have a vasectomy reversal. However, reversal is expensive and it does not always work.
A vasectomy is considered a permanent method of birth control. It is a simple operation involving cutting tubes in a man's scrotum called the vas deferens. These tubes carry a man's sperm. If no sperm can reach the outside of the man's body, he can not get a woman pregnant. Vasectomy does not affect a man's ability to ejaculate or to have sex.
Reversing a vasectomy is a much more complicated operation. Reconnecting the tubes can be difficult because of scar tissue and the size of the tubes. Also, preventing sperm from being released can cause permanent changes in sperm production. This means the man may not make enough sperm to get a woman pregnant or may produce sperm which do not work properly.
Procedures for Vasectomy Reversal
There are two types of surgery used for vasectomy reversal:
- Vasovasotomy
- Vasoepididymostomy
Vasovasostomy is a procedure to reconnect the cut ends of the vas deferens tubes. The surgeon makes an incision in the scrotum about two centimeters long. Using a special magnifying lens, he locates the ends, cuts away the closed-off segments, and reconnects the two parts using very fine stitches.
Vasoepididymostomy connects the end of the vas deferens tube on each side of the scrotum directly to the epididymis on the same side. The epididymis is a convoluted, tubelike structure that sits on the edge of the testicle. It's involved in preparing sperm so that it's able to fertilize an egg. It also has a place for sperm storage. The vas deferens tube emerges from the epididymis. Vasoepididymostomy is done when an obstruction in the vas deferens close to the epididymis, or in the epididymis itself, is stopping sperm from getting through.
In each type of surgery, the doctor will probably take a sample of fluid from the vas deferens to see if sperm are present. Observing healthy sperm is a clue that the surgery may be successful.
Success of Reversal
How well a vasectomy reversal works depends on how long it has been since the vasectomy, how skilled the surgeon is, and whether the man has any other medical problems or fertility issues. Vasovasotomy tends to have better success rates than vasoepididymostomy.
According to a study of vasovasotomy published in 1991, the chance of a couple getting pregnant after the procedure is:
- 76% if the vasectomy was less than 3 years ago
- 53% if the vasectomy was between 3 and 8 years ago
- 44% if the vasectomy was between 9 and 14 years ago
- 30% if the vasectomy was more than 15 years ago
After vasoepididymostomy, the chance of a couple getting pregnant ranges from about 11% to 56%. Success rates are lower than for vasovasotomy partly because sperm must be processed in the epididymis in order to be able to fertilize an egg. If they do not pass through the epididymis in the normal way, sperm may not work normally.
If Reversal Does Not Work
If the vasectomy reversal fails, there are other options. They include:
- "Second attempt" reversal
- Sperm retrieval and artificial insemination
A "second attempt" reversal may be worth trying if the first attempt did not reveal a lot of scar tissue and the doctor was able to detect healthy sperm. If the first surgery was a vasovasotomy, the second one may be another attempt to reconnect the ends of the vas deferens. If the first surgery left the vas deferens very short, or if there appears to be scar tissue near the epididymis, the second attempt may be the more complicated vasoepididymostomy. Men who needed a vasoepididymostomy as the first surgery or who have very extensive scar tissue may not be good candidates for a second attempt.
Sperm retrieval may be an option for men who are not able to have successful reversals or who choose not to have the reversal surgery. It involves using a needle to take sperm directly from the epididymis or the testicle. The sperm can then be used in one of several types of assisted reproductive techniques.
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Comments
Hi Penny, although it's slim, there is always a chance. There is less than a 1 percent chance of the vasectomy failing and letting sperm through. The chances are even smaller that your tubal ligation would have failed.
You're probably not pregnant, but if you're unsure go ahead and take a test.
-- Contributed by: HollySwansonjust wanted to know if theres a chance that i could be pregent? my husband has had a vasectomy and i had my tubes tied.
-- Contributed by: penny harveyThis page has been accessed 1,382 times. This page was last modified 06:03, 8 April 2006.
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