Both vasectomy reversal and ICSI/sperm aspiration are good alternatives to father a child after vasectomy. They each have advantages and drawbacks. In most situations vasectomy reversal offers the most desirable option for pregnancy. It requires one procedure be performed only on the man and couples can then try to get pregnant every month the old fashioned way in bed at home.

your first visit after the vasectomy reversal, we may check for sperm. After the six-week visit, a semen analysis should be performed every 3 months or until a pregnancy is established. While it is rare (<5%), some men can scar down even after good initial results and some men’s bodies have a reaction to the sperm (they produce antibodies against the sperm) that can interfere with fertility.

Yes, "transient patency" can occur with delayed blockage of the anastomosis at 6 months or later. This occurs about 3% of the time in successful reversals.

If we see whole motile sperm in the fluid coming from your testicle at the time of your vasectomy reversal, we can easily cryopreserve it as a safety backup. This can be used just in case inadequate numbers of sperm are seen after surgery in your ejaculate. Very rarely, vasectomy reversals can scar down even with good initial results. As a result, cryopreservation can be performed on ejaculated specimens early on during your recovery when the sperm quality is still excellent.

Dr. Buch was one of the first microsurgical vasectomy reversal specialists in the world to offer the option of freezing sperm at the time of the reversal. His early results were published in the medical journal Fertility and Sterility in 1994. Sperm cryopreservation offers another option for conception to our few couples who fail to return sperm to the ejaculate after what appears to be a technically successful vasectomy reversal at the time of surgery.

The major alternative to vasectomy reversal is a technique called sperm aspiration. Sperm aspiration is generally performed by one of two means: percutaneous aspiration or open surgical aspiration. In percutaneous aspiration, a fine needle is inserted into the testes or the epididymis under local anesthesia. Since only a tiny amount of sperm can be retrieved, […] Read more ...

Most men will recover from a vasectomy in a couple of days. We typically recommend taking it easy for 2 days, using ice packs and scrotal support, and then going back to work 2 or 3 days later. However, vasectomy reversals tend to take longer, depending on the type of work that the patient does. While some men can return to a desk job in 3 or 4 days, we recommend that heavy construction and lifting should be avoided for 4 weeks after a vasectomy reversal.

Often it is necessary to see a microsurgeon with experience in vasectomy reversals. By contacting the Royal College of Surgeons, they may be able to provide details of surgeons with experience in this area. Alternatively, your local doctor may be able to refer you to someone appropriate. Some public hospitals perform vasectomy reversals; you would need to speak with your local public hospital directly to see if they can help.

The return of sperm after vasectomy reversal may be immediate or may take up to 12 months. The difference lies in the type of the procedure required and the intra-operative findings. If there are high numbers of very motile (swimming) sperm at time of the vasectomy reversal and vasovasostomy alone is required than it is common for sperm to be present at the initial semen analysis at one or two months post-op.

There are certainly some patients who are better candidates than others; time from the vasectomy is not necessarily a reason not to have a reversal. However, in the case of a couple where the woman has, for instance, had a tubal ligation, sperm aspiration combined with in-vitro fertilization is probably a better choice than performing vasectomy reversal followed by tubal ligation reversal.

Prior to a vasectomy, the patient and his partner should be absolutely sure that they are done having children. There are no special preparations in terms of abstaining from ejaculation prior to either the vasectomy or the reversal. The patient should be aware that a vasectomy reversal is a more expensive procedure than the original vasectomy and likely will take longer to recover.

A male fertility specialist has been specially trained to perform microsurgical vasectomy reversals. The specialist is also trained in male infertility and can provide proper consultation about your options. General urologists typically have not had any specialized training outside of the urology residency and tend to perform less vasectomy reversals on an annual basis than specialists.

The advantage of ICSI is the possibility for some couples to establish a pregnancy quicker than with vasectomy reversal. We recommend ICSI/sperm harvesting in those situations where vasectomy reversal would be difficult or impossible, the female partner is of advanced reproductive age, or when there is also a female factor contributing to the infertility. Each couples' circumstances are unique and need to be addressed on an individual basis.

It is a process through which an individual sperm is injected inside the oocyte. It is often used for men with very poor sperm counts or in some cases, where no sperm in the ejaculate and we use testicular sperms.

ICSI is "Intra cytoplasmic sperm injection" - a procedure by which the sperm is physically introduced into the ova by the embryologist using micromanipulation techniques.

They dissolve and are absorbed into the body. Dead and unused cells are absorbed by the body throughout life. Antibodies to sperm develop in 50 percent of men who have vasectomies. Normally, antibodies protect the body against viruses and bacteria. Sperm antibodies will not affect your general health. But they may lessen the chance of restoring fertility if vasectomy is reversed.

Because of the extremely small size of the sperm duct, even a perfect repair using microsurgical techniques can sometimes fail to remain open. In uncomplicated reversals where sperm is present at the time of surgery, this occurs at most about 3-4% of the time (about 1 in 25 men). In complex repairs involving the epididymis […] Read more ...

It is impossible to perform a good vasectomy reversal without extensive training and special experience in microsurgery, especially reconstructive procedures such as vasoepididymostomy (VE). A physician should perform 20 to 100 vasectomy reversals a year to maintain expert proficiency. Most general urologists perform 0 to 2 vasectomy reversals a year.

In most cases, failed reversals are due to technical mistakes by the surgeon. A second attempt for a vasectomy reversal is still less expensive and the most effective choice for a couple to have a child. Since each case is different, specialists like Dr. Bastuba can evaluate your situation and offer you a solution. (Read our information about failed vasectomy reversals)

Of the last 700 patients, 97% if the vasectomy was less than 13 years ago, 93% overall including redo vasectomy reversals and patients out to 33 year. My success rates are based on a postoperative semen analysis showing more than one million motile sperm in the sample. The overall success rate for just redo vasectomy reversals is 85% however the rates tend to be better than 85% if less time has passed since the original vasectomy and the reversal.

The sperm quality should return to normal 3 to 6 months following a reversal as it takes that long for the testicles to make new sperm. However, the count and the motility may be lower after reversal due to partial blockage or scarring.

Following a vasectomy, the testicles will decrease the number of sperm that they produce. Second, the body will increase the process of sperm breakdown and reabsorption. Over a period of time, the equilibrium between sperm production and sperm reabsorption is fine tuned.

Sperms continue to be produced as before but since they do not come out of the body after the operation they get absorbed into the body. This is a normal process which occurs even in non vasectomised men who do not have sex for sometime.

Antibodies are molecules produced by the immune system to fight off anything that the immune system perceives as being foreign. After a vasectomy many men begin making antibodies to their sperm that can be detected in their bloodstream. When present, antibodies can attach to the sperm and prevent them from moving (decrease motility) or from penetrating an egg. It has become clear that only antibodies present on the sperm may cause a problem in certain situations.

mentioned above, the sperm behind the vasectomy (i.e. in the testicle or epididymis) are unable to fertilize eggs on their own. They can be used in IVF-ICSI to achieve reliable pregnancy rates of approximately 50 % per try at a cost of $12,000 (relative average success rates and costs in Dallas/Ft. Worth). A sperm retrieval procedure the day of the IVF-ICSI has an average cost of $3,000.

The vas deferens is very small and can only be properly reconnected if using an operating microscope to allow for adequate visualization of the vas deferens.

The longer the time interval from the vasectomy the higher the chance of epididymal blockage occurring requiring a Vasoepididymostomy to reconnect, this lowers the success rates. Success rates for a bilateral (both sides) Vasoepididymostomies are about 85% at MMHC's National Vasectomy Reversal Center.