Men and Vasectomy
One-tenth of men who get a vasectomy change their minds later, said a professor of urology at Baylor College of Medicine in Houston.
"This is most commonly because of remarriage," said Dr. Larry Lipshultz. "Vasectomy reversals are also requested by couples who have merely 'changed their minds,' as well as by couples who have lost a child and are attempting to initiate another pregnancy."
During the delicate procedure, surgeons find the two ends of the vas deferens and free them from the scar tissue. Once it's determined that the fluid in the vas contains sperm, the two ends are sutured together, thus reversing the vasectomy. The operating time is usually around three hours, said Lipshultz.
However, not every vasectomy is reversible, he said.
"When the vas is opened, fluid will flow from the testicular side of the vasectomy site," said Lipshultz. "If sperm are present, then we expect most patients to demonstrate a return of sperm with an associated 60 to 70 percent pregnancy rate. If no sperm are present, yet the vasectomy fluid looks abundant and appropriate for ultimate sperm production, then the reversal is performed with a successful outcome in approximately half of all patients."
If poor-quality fluid is present and sperm are absent, or no fluid at all is found, then a procedure called an epididymovasostomy (connection of the vas to the epididymis, or the chord along the border of the testes that provides storage and transport of sperm) is performed with a successful outcome of approximately 40 to 50 percent.
Sperm banking is routinely performed at the time of vasectomy reversal if whole sperm are present. Cryopreservation, or freezing the sperm, is performed as a backup in case inadequate sperm counts are present after surgery.