Microsurgical Vasectomy Reversal
Vasectomy reversal is a highly effective microsurgical operation which can restore an open vas deferens in the overwhelming majority of procedures. The functional success rate of vasectomy reversal is impressive with restoration of sperm over 90% of the time for the average man undergoing the operation. Pregnancy occurs in up to 85% of couples when the female partner's age is less than 35 years and between 50% to 70% for the average couple having their vasectomy reversed.
Cost of vasectomy reversal
Vasectomy reversal is provided at reasonable cost as a result of an agreement between my anaesthetist, the hospitals at which I operate and myself allowing control and consistency on the expense of the procedure. If you have health insurance and medicare the cost can be as little as $3,100. For those without insurance $6,600.
Deciding between vasectomy reversal and IVF ?
You may be trying to choose between vasectomy reversal or IVF. It is best to consider this decision not as an 'either-or' issue but rather a question of what order you should undergo each treatment. By this I mean whether vasectomy reversal or IVF is the wisest first choice.
I generally recommend vasectomy reversal as the first step. It is a single procedure and usually means that your partner can avoid IVF (and you a surgical sperm retrieval).
Also important in this decision is that sperm extraction for IVF either from the epididymis (PESA procedure) or testis (TESE procedure) runs a risk of damaging the outflow path of sperm from the testis and therefore reducing the prospect of future successful vasectomy reversal. On the other hand if vasectomy reversal is undertaken first then for the average case 90% of men will achieve the presence of sperm. If pregnancy does not occur naturally the presence of sperm simplifies IVF (no need for surgical sperm retrieval).
This means the cumulative pregnancy rates of the sequence vasectomy reversal followed by IVF is more likely to be successful than IVF followed by vasectomy reversal. So while IVF is an excellent treatment when undertaken at a high quality IVF clinic such as Genea it is my view that in most cases vasectomy reversal is the wisest first choice.
Predictors of successful vasectomy reversal
There are a range of predictors of successful vasectomy reversal which you should consider when making a decision to reverse your vasectomy. These include the length of time from your initial vasectomy to its reversal, your partners age and if you have had a prior IVF sperm extraction. The expertise and experience of your surgeon matters.
Need more detail ?
Dr Woolcott (now retired whose practice I am continuing) wrote an article for the Australian Doctor journal intended for General Practitioners describing in fine medical detail all aspects of microsurgical vasectomy reversal including information on pre-operative assessment, alternative surgical methods, post operative care and assessment of outcome.