Vasectomy reversal success rates and results
The results from vasectomy reversal are exceptional with the restoration of fertility in over 95% of men and successful pregnancy in up to 80% of couples. This is particularly so when the duration from vasectomy to reversal is less than 10 years and the age of your partner is less than 35 years.
Success from vasectomy reversal can be measured in three different ways. The first is the technical ability to microsurgically resect the site of vasectomy and to re-connect the vas deferens so that it is open at the completion of the operation. The second is the practical success of your operation: which means whether the surgery has led to the return of sperm. The third and most important is functional success which is whether successful pregnancy is achieved.
Surgical success - Repair of the vas deferens
Over the last 30 years I have microsurgically re-joined more than 6,500 vas deferens following prior vasectomy. At a microsurgical level it is possible to reverse vasectomy and to achieve successful re-opening of the vas deferens 99.5% of the time. This means that at the time of surgical reversal of vasectomy that I am certain that I have re-connected the vas deferens and that the site of the prior vasectomy is open. The healing process at the site of the microsurgical join will determine if sperm is able to flow and practical success is achieved.
To date there has only been 8 vasectomy sites in 7 men that I have been unable to reconnect. Put another way there has been only one man for whom it was impossible to reverse his vasectomy on either side and six others where it was not possible to do so on one side.
Practical success - Return of sperm
Sperm returns in approximately 95% of men who have a vasectomy reversal under my care. The outcome is higher for those with a shorter time from vasectomy to reversal and less for those with longer durations. For those with a vasectomy to vasectomy reversal interval of 10 to 15 years sperm returns in about 90% of the time.. For men with more than 15 years from vasectomy the success rate is approximately 80%. When vasectomy has been present for more than 20 years sperm returns in about 70% of men.
Sperm usually returns gradually and in a progressive manner such that for the average man undergoing vasectomy reversal by 6 weeks after surgery approximately 50% of men will have sperm present; by 10 weeks this rises to 80%; by 12 weeks to 90% and by 6 months to 95%.
Real success - Pregnancy Rates
For the average patient undergoing microsurgical vasectomy reversal the overall postoperative pregnancy rate is high at 50% to 80%. When female age is less than 35 years and the duration of time between vasectomy and reversal is less than 10 years up to 85% of couples achieving successful pregnancy.
Your personal probability of achieving a successful pregnancy after vasectomy reversal is dependent on two key factors:
- The duration of time since vasectomy
- Your partner’s age
The single most important factor influencing pregnancy rates and take home baby rates following vasectomy reversal is female age. The younger your partner the higher the chance of successful pregnancy.
The shorter the time since the vasectomy, the higher the chance of a successful reversal. This is due to back pressure effects on the testis causing damage to sperm production. In addition the very fine tubule (epidermis) just next to the testis is damaged by this pressure and can break open and then scar over so that there is a second blockage very close to the testis.
Health of babies following vasectomy reversal
Some doctors recommend waiting up to six months following vasectomy reversal before attempting achieve pregnancy. Their reasoning for making this recommendation is a fear that there may be an increased risk of having a baby with congenital abnormality. The basis of this fear stems from a study undertaken in the 1990's which was designed to determine is there was an increase proportion of sperm with extra or missing chromosomes in the semen of men following vasectomy reversal - the results suggested there was and the authors of the study conclude.
However, (1) the study was very small with less than 50 men enrolled (2) no subsequent study has repeated the findings, (3) there are no studies which demonstrate an increase risk of abnormal babies in men following vasectomy reversal once the results are adjusted for female age [which is by far the most important risk factor] and (5) studies into couples undertaking IVF where man has had a prior vasectomy which has not been reversed similarly do not show an increased risk of producing babies with congential abnormality.
It is up to you should wish to be extremely cautious and wait 4 to 6 months before trying to conceive but the current state of scientific evidence is that risk of having an abnormal baby is not more (and no less) than it would otherwise be without having had a vasectomy.
Predictors of successful vasectomy reversal
The are a range of other influences on and predictors of successful vasectomy reversal including the type of vasectomy, post vasectomy testicular damage and in particular, prior IVF sperm extraction procedures.
Choice of surgeon - Why experience matters
Of all the things that yo can control to maximize the chance of successful vasectomy reversal the most important is your choice of doctor. As there is a wide range of experience and expertise in doctors performing vasectomy reversal in Australia, the number of operations a surgeon performs is an major influence on success rates. More than 95% of surgeons perform less that 10 vasectomy reversals per year so choosing the a specialist reproductive microsurgeon who performs large numbers of vasectomy reversal operations is exceptionally important.
My clinical practice's sole focus is fertility microsurgery and currently I am the only full-time reproductive microsurgeon practising in Australia. I perform hundreds of microsurgical vasectomy reversal operations each year and have done so every year for the last 25.
Detailed information on vasectomy reversal
For those who want to research the fine detail about vasectomy reversal I was commissioned to write an article for the 'Australian Doctor' journal, which is supplied to all General Practitioners in the country. In it you can read all of the information I provide to doctors who refer me patients for vasectomy reversal.