Fertility Treatment
Vasectomy Reversal
A surgery that undoes a vasectomy hopefully restoring a man’s fertility.
What is a Vasectomy Reversal?
A vasectomy reversal is a surgery done to undo a vasectomy by reconnecting each vas deferens tube that carries sperm from the testicles to where the semen is stored.
Many factors affect whether a reversal is successful in achieving subsequent pregnancy. Factors that contribute to the success include both the type of reversal, the time since the vasectomy, the female partner’s age, the surgeon experience, and previous fertility issues prior to the vasectomy.
What to Expect
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Before The Procedure
- Your doctor will:
- Ensure there are no health concerns that could complicate surgery via medical records and physical exam.
- Ensure the ability to produce healthy sperm. For most, simply having fathered children previously is enough evidence. In some cases, your doctor may recommend additional testing.
- Ensure that your partner does not have any fertility issues, particularly if the partner does not have any children or is older.
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During The Procedure
At the onset of your Vasectomy Reversal, you will be put under general anesthesia.
The surgeon will start with a small incision on the scrotum to expose the tube vas deferens.
The doctor will then cut open the sections of the vas deferens attached to the epididymis to examine the fluid inside. If sperm are present in the fluid, the ends of the severed vas deferens can be connected to re-establish the passageway for sperm. This method of Vasectomy is called a Vasovasostomy and is reliant upon sperm being found in the vas deferens.
If the fluid does not contain sperm the doctor may choose to perform a vasoepididymostomy in which the proximal portion of the deferens is connected directly to the epididymis.
- Sometimes a combination of the two surgical techniques (a Vasovasostomy for one side and a vasoepididymostomy for the other).
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Post Procedure
To finish the surgery, your doctor will close the incisions and cover them with bandages. While this is an outpatient procedure, you will likely be sore for several days and it is very important that you follow all instructions provided by your surgical team in regards to care and lifestyle for the upcoming weeks.
You will likely need to wear tightfitting underwear, apply ice at frequent intervals for 24 to 48 hours to reduce the swelling, avoid wetting the bandages for the first few days, abstain from sexual activity for two to three weeks, limit activities for 6 to 8 weeks- particularly any athletic activity that could pull or otherwise harm the testicles
Due to the limitations on activity, you may need to delay going back to work past a few days – particularly if you perform physical labor of any kind.
Considerations
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Sperm Freezing
You may have the option to harvest and freeze sperm during the vasectomy reversal procedure. This could be something to consider as a backup plan. Should the reversal not be successful, you would have frozen sperm to be used in conjunction with IVF to help build your family.
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Sperm Extractions: PESA TESA TESE
PESA, TESA, and TESE are variations of similar procedures in which sperm is extracted from the testes for use with IVF. This may be well suited for couples who may have other fertility issues at play and should be considered as a treatment option with your fertility specialist.
