Whether considering vasectomy reversal to enable natural parenthood or another reason, you may wonder if your fertility will return, and if so, to what degree. The procedure has been found to offer effectiveness rates as high as 90-97%. This includes improvements for both sperm delivery and pregnancy rates, although its success relies on your surgeon’s abilities and other factors. You, your partner, and your urologist should thoroughly discuss the procedure, including the specific process and its merits.

Vasectomy Reversal: Defining Surgical Success

In the United States, each year, about 3-6% of the 300,000 vasectomy patients have a reversal. Your fertility’s restoration is best indicated by two key parameters:

• Patency – Unblocked sperm delivery, this indicates how much sperm has returned to your ejaculate, typically within two months after the surgery. Proof of patency requires a stable semen analysis test, which may take up to 12 months to report.  
• Pregnancy – Measuring a couple’s post-surgical conception success, pregnancy rates may vary, based on male and female factors, like testicular issues, or a woman’s age or fertility issues. As such, pregnancy rates are typically lower than patency rates. Another contributing factor is vasectomy location, as reversal may be more difficult when closer to the testicle, requiring a vasoepididymostomy. 

Vasectomy Reversal: The Processes and Surgical Role

With this procedure, an open tube (lumen) is restored within the vas deferens (vas), which moves sperm from the testicles into the epididymis, a coiled tube, where sperm mature and develop motility (movement). The vas can then aim and propel sperm into the urethra, the tube removing urine from your bladder and body, and also where sperm and other fluids form ejaculate. 

Selecting the Surgical Technique(s)

You’ll have one (or both) of two reattachment surgical techniques, depending on the time since your vasectomy, and chosen by your surgeon, just before the procedure, by analyzing vas fluid to view sperm. Vasovasostomy involves each severed vas ending being reattached to a healthy segment, measuring around one-third of a millimeter in diameter. The more complex technique, vasoepididymostomy, involves the severed vas being reattached directly to an epididymal tubule. As this tubule is typically one-third to one-half of the size of the vas tubule, vasovasostomy is generally preferred. 

The Need for a Qualified Microsurgeon

Key to procedural success is the surgeon’s skill and knowledge. Optimally, they should be board-certified in urology and trained in microsurgery, utilizing surgical instruments able to magnify images up to 40 or 50 times, allowing for delicate tissue disconnection and reconnection. Other beneficial qualifications include having experience in performing full procedures alone, and addressing questions and success rates. 

For instance, Dr. Martin Bastuba, a board-certified vasectomy surgeon with specialized microsurgical training, and the Medical Director of Male Fertility & Sexual Medicine Specialists (MFS), has long performed this procedure. He’s achieved average patency rates of 99% for both techniques, while for pregnancy rates, vasovasostomy success rates of 65%-75% and vasoepididyostomy success rates of 40%-60% are common.  

Research How Fertility Returns After Vasectomy Reversal

A vasectomy reversal typically allows men to regain previous fertility levels, through the measurement of such criteria as patency and pregnancy levels, and the surgeon’s experience. Evaluate your procedural results and discuss future outcomes with your urologist. If you want to schedule a consultation with Dr. Martin Bastuba, or for general fertility questions, we invite you to contact us today.