Our success rates at the Vasectomy Reversal Center of America are among the highest outcomes nationally, with over 90 percent of our patients having a normal number of sperm in their ejaculate by 6 to 8 months.
Our pregnancy success is 70%. Dr. Boyle and Dr. Fenig are able to provide this high degree of success for their patients even in the most complex cases including re-dos and the more delicate microsurgery called epididymovasostomy. The number of years from vasectomy to vasectomy reversal is not an issue and our microsurgeons have had success performing vasectomy reversals on patients whose vasectomies were performed 40 years ago and even longer.
Outcomes are important as the number of reversals the microsurgeon performs and their personal success rates reflect their expertise. There are two microsurgery procedures that can be performed when doing a vasectomy reversal. One is a vasovasostomy, where the vas deferens is reattached to the vas deferens. The other procedure is an epididymovasostomy, where the vas deferens is connected to the epididymis. The decision as to which reconstruction needs to be performed is made at the time of surgery.
Sperm are made in the testicle, and then go to the epididymis, where they learn how to swim and mature. They then travel into the vas deferens. Prior to a vasectomy, sperm traveled in the vas deferens and mixed with fluid from the prostate and seminal vesicles and were expressed in the ejaculate.
Since the time of the vasectomy, you presumably have been making sperm (assuming there has been no use of testosterone, steroids, radiation or chemotherapy), which then hit a wall where the vasectomy was done.
Several different things can then happen to the sperm. They can die and get reabsorbed by the body. They can leak out the end of the vas deferens and form a small cyst or spermatocele. Or, they can back up into the epididymis and cause a blockage there. It is important to ascertain that a blockage has not formed in the epididymis, and this is more common the farther out you are from your vasectomy. By examining the fluid from the testicle side of the vas deferens, the microsurgeon can determine if a secondary blockage is likely.
If the fluid from the vas is clear and free flowing, and sperm are present in this fluid, the microsurgeon will perform a vasovasostomy. The success rate for this procedure is close to 95 percent, with an associated pregnancy rate of 75 percent. If the fluid is similar in quality, clear and free flowing, but no sperm are present, the microsurgeon will still perform a vasovasostomy, but the success decreases to approximately 80 percent. If the fluid is poor quality, meaning there is no fluid or it is thick and pasty, a blockage in the epididymis has occurred and the microsurgeon will perform an epididymovasostomy, with an average success rate of 60 percent.
Since success rates at the Vasectomy Reversal Center of America are over 90 percent, this reflects that most patients are able to have vasovasostomies, but it is important to choose a microsurgeon who can perform an epididymovasostomy in the event this is necessary.