Some men who have had a vasectomy will decide later that they want to have more children. This can be achieved by either a vasectomy reversal or assisted reproductive technology such as IVF.
What is a vasectomy reversal?
A vasectomy reversal or vasovasectomy is a surgical procedure performed using microsurgery to reconnect the vas deferens cut during a vasectomy.
A vasectomy reversal is a day only procedure conducted under general anaesthetic. Surgery usually takes 2 – 4 hours and requires at least a week for recovery to aid healing and prevent injury. Ejaculation must not occur for two weeks and no strenuous activity should be undertaken until discomfort and swelling have disappeared.
A semen analysis is conducted at 6 – 8 weeks following surgery to evaluate success of re-establishing the sperm pathway.
Vasectomy reversal success rates
Success of a vasectomy reversal is measured in two ways – return of sperm and pregnancy success.
After a vasectomy reversal sperm usually returns progressively and by 3 months 90% of men will have sperm present.
Success depends on the degree of damage to the vas deferens during the original operation as well as the time passed since the vasectomy. After 10 to 15 years the chances of a successful reversal fall significantly.
When performing a vasectomy reversal you are usually not just looking for sperm to be present but to achieve a successful pregnancy.
The success of having a baby after a vasectomy is affected by both male and female factors including
- the presence of anti- sperm antibodies which can interfere with sperm motility and fertilisation
- the age and fertility of the female partner
Age of the woman is the single biggest factor influencing a couple’s chance of conceiving. The female partner’s fertility should be assessed to determine egg reserve and existence of any fertility issues such as PCOS, endometriosis or fibroids.
It is important that a couple is assessed together when considering a vasectomy reversal to determine which path will give the best chance of a having a baby.
Using IVF after a vasectomy
Depending on a couple’s individual circumstances an IVF cycle with intracytoplasmic sperm injection (ICSI) may be recommended.
In this case a surgical sperm collection is conducted to retrieve sperm from the epididymis or testis. One sperm can then be injected, using intracytoplasmic sperm injection, into the eggs collected from the female partner as part of an IVF cycle.
Should I have vasectomy reversal or IVF?
For the right candidate a vasectomy reversal can be an effective procedure to help a couple conceive after a vasectomy.
When deciding whether to have a vasectomy reversal or use assisted reproductive technology it is worth considering the following factors:
- How long has it been since the original reversal and what type of surgery was it? This can affect the technical success of the reversal.
- Age and fertility of the female partner? This will affect your chances of conceiving naturally.
- Are you planning one or many children? If only one, maintaining the vasectomy as a form of contraception may be important in the long run.
- Comparative cost of surgical and ART treatment.
Advantages of seeing a fertility specialist about a reversal
At IVF Australia our fertility specialists are not only highly skilled fertility surgeons but have the knowledge and experience to assess the fertility of the female partner.
If a vasectomy reversal is not deemed viable they will be able to outline appropriate alternatives such as IVF.
Vasectomy reversals at IVF Australia are performed at our Day Hospitals with an embryologist on hand for intraoperative sampling of sperm. This enables the fertility specialist to check the sperm can flow unobstructed and if a blockage is identified to be able to perform a bypass operation called a Vasoepididymostomy where the vas deferens is connected directly to the epididymis.
Vasectomy reversal or IVF?
If you or your partner have had a vasectomy and are considering your options for having more children, we recommend you consult a fertility specialist. A fertility specialist can assess you as a couple, give you advice on which course of treatment will give you the best chance of having a baby and perform the vasectomy reversal surgery.
To book an appointment with a fertility specialist please complete the form below or call 1800 111 483. Appointments are available within the next couple of weeks and will cost approximately $150 for a couple after the Medicare rebate.