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A woman’s guide to understanding vasectomy reversal

When it comes to vasectomies, most men mistakenly think that their partners aren’t that concerned about the procedure. In fact, women want to know exactly what’s going on. This process involves them too, and while you may not exactly look at it that way when you’re the one sitting in bed with an ice pack down below, the truth is your partner has many questions she would like to have answered. Here are some common questions women have about vasectomy reversals.

How soon after the vasectomy reversal can we have sex?

In most cases, it is recommended to wait four weeks before resuming a sexually active lifestyle. With that said, it can take anywhere from one to 18 months before sperm begins showing up in the semen.

Does the vasectomy reversal change a man’s ejaculation?

Contrary to common belief, sperm only accounts for two to five percent of a man’s semen. A vasectomy reversal plays no part in how much seminal fluid is released during ejaculation. It will not significantly result in more or less semen, nor affect the intensity or duration of the man’s orgasm. In some cases, a man who experienced chronic pain after his vasectomy may find that the pain is gone after his vasectomy reversal.

How soon after the vasectomy reversal can I expect to become pregnant?

Pregnancy is dependent on a variety of issues. These include the duration of time that has elapsed between the original vasectomy and the reversal procedure, the age and health of the woman as well as many other factors, including the health of the man and his sperm. If the reversal is successful and (healthy) sperm rejoins the seminal fluid, a woman stands a good chance at getting pregnant within the first year. Sometimes pregnancy occurs right away or within the first few months. Remember – a vasectomy reversal is not guaranteed to result in a vasectomy reversal pregnancy.

How long will my husband be in pain and what can I do to help?

Your husband will experience swelling and tenderness for up to four weeks, although over this time the pain and swelling will be subsiding progressively. Most men are only really sore for the first three to five days after the vasectomy reversal. During this period, you can make sure your partner stays at rest and has a nice steady supply of ice packs at the ready. Other than that, good old TLC is the best medicine.

I want a child but my husband doesn’t want to have a vasectomy reversal. Is in vitro fertilization a better option?

One of the drawbacks of the in vitro fertilization process (VF) is that it often results in multiple births, such as twins, occasionally triplets or more. A vasectomy reversal increases the chance of a successful pregnancy while minimizing the risk of a multiple-birth situation which many couples may not be prepared to deal with. Twins results in lower birth weight babies and a higher chance of premature babies. Triplets can be a very high-risk pregnancy. Also the added stress on the womans pelvis can increase her risk of urinary incontinence and prolapse. The hormone injections which a woman must take contain a level of discomfort and risk as well. In addition, the IVF procedure is a much costlier undertaking. Nonetheless, in vitro fertility treatments are required for some couples due to other fertility obstacles they may have and it are a viable option for those couples who choose them. Most top level vasectomy reversal surgeons usually work with top in vitro fertility doctors to perform sperm retrieval surgery on the men in couples who prefer this approach. Sperm can be retrieved surgically from the testicle and used for in vitro fertility treatments, but it cannot be used for intra-uterine insemination—only ejaculated sperm can be used for intra-uterine insemination.

Can a sperm retrieval be done at the time of the vasectomy reversal?

Yes, sperm can be extracted with minimal risk at the time of a vasectomy reversal. The sperm is inspected in real time by a scientist in the operating room to ensure there is enough for at least four or five cycles of in vitro fertility treatments. The sperm is then frozen and stored at a sperm bank. The reason a patient may select to have sperm extracted at the same time as the reverse vasectomy is to provide a back-up source of sperm that can be used in the in vitro fertilization process without the need for an additional surgery at another time. Many men choose to have sperm frozen particularly if it has been a longer interval of time since their vasectomy.

Hey Doc, is my vasectomy reversible?

One of the greatest medical misconceptions is that a vasectomy is a permanent physical alteration. In reality, a reversible vasectomy is possible. The procedure is a delicate one, but it is possible.

How is a vasectomy reversible?

A traditional vasectomy reversal is called vasovasostomy. During this procedure, the physician sews the severed ends of the vas deferens back together. Sometimes this is possible and sometimes it is not. In some cases, the tubes between the testicle and the vasectomy scar, known as the epididymis, can become very congested and rupture and scar and therefore remain permanently blocked even after the vasectomy scar is bypassed.  This is often referred to as a “blow out.”  Reconnecting the tubes therefore would not result in restoring the flow of sperm when the sperm flow is blocked by a “blow out.” In this case the surgeon will have to perform a bypass of both the vasectomy scar and the blockage in the epididymis and connect into the part of the epididymis that is not yet blocked. This is called a vasoepididymostomy. During this procedure, the vas deferens is connected directly to the epididymis (the tube in which the sperm becomes active).

vasovasostomy-1 vasovasostomy-2

The vasovasostomy bypasses the vasectomy scar to bring the ends of the vas deferens together from above and below the scar to allow the sperm to flow out. The sperm form in the tiny tubules of the testicle and migrate out through larger tubules into the epididymis. The very small tubules of the epididymis feed into one slightly larger tube wihich eventually thickens and straightens to become the vas deferens which conducts the sperm up to the urethra of the penis.

Why would anyone want a vasectomy reversal?

People change their minds. Sometimes, one’s life may take a change, such as a new relationship and a new opportunity to start a family, or a couple realizing that they do want to increase the size of their family after all. Regardless of the reason, between six and twelve percent of vasectomized men choose to have their procedure reversed.
It’s important to know that men’s bodies continue to produce sperm even after a vasectomy is performed. Because the sperm are unable to pass through to join the seminal fluid due to the vasectomy, they build up, eventually break down and get harmlessly reabsorbed by the body.

How successful are vasectomy reversal procedures?

With improved microsurgical vasectomy reversal techniques, vasectomy reversals have become not only more popular, but more effective. Even still, there is no guarantee that a vasectomy reversal will result in pregnancy. Our experience is that across all patients, regardless of age and time since vasectomy sperm recovery occurs successfully in over 90 percent of vasectomy reversal patients, and of those patients, at least 50 percent achieve vasectomy reversal pregnancy.

Are vasectomy reversals covered by insurance?

Every healthcare insurance provider is different, but most do not cover the vasectomy reversal procedure since it is considered an elective surgery. Of course, before making your decision, be sure to check with your insurance company to learn if that is the case with your policy. In the typical situation, the insurance company will not cover the cost of the vasectomy reversal; however, if desired, financing options are available.

Having second thoughts About your vasectomy? Reverse it!

One of the most effective forms of birth control a couple can use is for the male to undergo a vasectomy. This is accomplished through a surgical procedure in which the vas deferens (the tubes that deliver sperm) are severed and tied off. But what happens if your life takes an unexpected turn, like marriage or a financial upswing, and the family you never thought you were going to want, now suddenly seems like a good idea? One of the best options available is to undergo a vasectomy reversal procedure.

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Need more information before you make a decision? No problem! Get a free consultation with Dr. Spitz to determine the best solution for your family.

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Understanding how a vasectomy reversal is performed

A traditional vasectomy reversal is called a vasovasostomy. During this procedure, the physician sews the severed ends of the vas deferens back together. Sometimes this is possible and sometimes it is not. In some cases, the tubes between the testicle and the vasectomy scar, known as the epididymis, can become very congested and rupture and scar and therefor remain permanently blocked even after the vasectomy scar is bypassed.  This is often referred to as a “blow out.”  Reconnecting the tubes therefore would not result in restoring the flow of sperm when the sperm flow is blocked by a “blow out.” In this case the surgeon will have to perform a bypass of both the vasectomy scar and the blockage in the epididymis and connect into the part of the epididymis that is not yet blocked. This is called a vasoepididymostomy. During this procedure, the vas deferens is connected directly to the epididymis (the tube in which the sperm becomes active).

vas_defrens vasoepididymostomy

Sometimes the back pressure from the vasectomy blockage causes a tubule in the epididymis to rupture, scar, and form a new level of blockage. This is known as a “blow out.” When there is a blockage in the epididymis due to a “blow out” then the vas deferens must be connected from above the vasectomy scar to above the blockage of the epididymis to allow the sperm to flow out. This connection is called a vasoepididymostomy.

Is a vasectomy reversal guaranteed to work?

While vasectomy reversal success rates are greatly increased when performed by a male reproductive specialist who is fellowship-trained in microsurgical vasectomy reversal, the truth is they are not a 100 percent fool-proof solution. Many different variables must be taken into consideration when looking at the pregnancy potential for every couple. Your partner’s age, state of health and other factors do make a difference. Consequently, the time that has lapsed between the original vasectomy and the vasectomy reversal procedure also plays into success rate for patients.
Studies indicate that men whose wives are normally fertile and who had their vasectomies between 20 and 25 years ago, stand a 33 percent chance of getting their partners pregnant. Men who had their vasectomy between 15 and 19 years ago stand a greater chance at about 50 percent. Shorter intervals are associated with higher success rates up to 80 percent in cases where the vasectomy is within two or three years.
To be provided with the absolute best chance at experiencing vasectomy reversal success, you should consider a surgeon who is specially trained in microsurgery and male fertility. Because a vasectomy reversal is a much more complex and delicate procedure than the initial vasectomy, microsurgery expertise makes it possible to live your dream of building a family, even after years of being told there was no way possible. Furthermore, if there is a male infertility obstacle that may prevent you from having vasectomy reversal success, a male fertility expert will be able to determine that ahead of time and provide the best fertility treatment options.

What to expect from vasectomy reversal surgery

Choosing to undergo a vasectomy was once considered a lifelong decision. But, thanks to modern advances in microsurgery, vasectomy reversal surgery makes it possible for families to grow when life situations change.

Is reverse vasectomy surgery safe?

Vasectomy reversal surgery is a very safe procedure that requires no in-hospital stay.

How long does reverse vasectomy surgery take?

Vasectomy reversal surgery is a much more meticulous and technical procedure than the original vasectomy. Depending on the case, it can take from 2.5 to 4 hours to complete. In some cases the more complex vasoepididymostomy may be performed as well as sperm retrieval for freezing. Because general anesthesia is applied, recovery time in the outpatient area should be factored in as well.

Does reverse vasectomy surgery hurt?

Your physician will administer local as well as general anesthesia during the surgery in addition to a mild sedative prior to the microvasectomy reversal. This helps eliminate any pain while in surgery. Post-surgery, one can expect to have slight swelling, tenderness, bruising or discoloration in the scrotal area. One may also experience a headache, nausea or body aches, which are simply the after effects of the anesthesia. If you experience lasting or significant pain, contact your doctor immediately.

What should I do when I get home from reverse vasectomy surgery?

Your doctor will probably advise you to rest with your legs elevated. This will help to keep the swelling to a minimum. You may also be required to wear a support garment like a jock strap for a period of time after the microvasectomy reversal. Avoid taking tub baths or submerging your body in water for at least 48 hours after the vasectomy reversal surgery. You will be prescribed pain relievers to help you manage any postsurgical pain, so take them as prescribed.

When will I be able to return to my regular routine?

In routine cases, it will take about three to five days to return to office level activity and one month to return to unrestricted activity including exercise and sex.

Can my wife get pregnant immediately after my reverse vasectomy surgery?

It is usually advised to abstain from sexual activity for at least four weeks after your reverse vasectomy surgery. Many women have become pregnant immediately upon resuming sex. Even so, it is not entirely likely your sperm will have returned to regular count and motility. In fact, in can take several months for your sperm count to return to what’s normal for your age. You can expect your doctor to schedule a semen analysis about two months after your microvasectomy reversal surgery to check on the counts, motility (movement) and appearance of your sperm.

Get all your questions about male fertility and microsurgical vasectomy reversal answered by Aaron Spitz, MD today. Call us at 888.532.4358 or use our convenient online Request an Appointment form to schedule your consultation. Our service area includes Los Angeles County, CA (Torrance, Los Angeles, Beverly Hills, Santa Monica and Long Beach) and Orange County, CA (Irvine, Huntington Beach, Newport Beach, Laguna Niguel and Mission Viejo).

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