A Man's Prerogative
Half a million men have a vasectomy every year, but 2-6% of them, some 10,000-30,000 men, decide to have a vasectomy reversal at some later point in time. In vasectomy reversal, the ducts that transfer the sperm into the testes are reconnected. Some of the reasons a man may decide to have a vasectomy reversal are the loss of a child, a new marriage, improved finances, or in rare cases, to treat testicular pain that arises as a complication of vasectomy.
Vasectomy reversal tends to be a very successful means of restoring male fertility, though the chances of having healthy sperm decrease if more than 15 years have elapsed since your vasectomy. That means there is less of a chance for fathering a child.
Vasectomy reversal is a more complicated procedure than a vasectomy. The surgery is not often covered by insurance and can cost between $5000-$12,000 or more. The procedure is done in a hospital or surgery center and involves microsurgery, a delicate technique. You'll want an experienced doctor who has performed many of these surgeries and has a high success rate of vasectomy reversal followed by conception. The surgery is most often an outpatient procedure, and you will need someone to drive you home after the 2-4 hour procedure.
There are two surgical methods of vasectomy reversal:
Vasovasostomy--The surgeon sews the ends of the vas deferens back together. This is the easier of the two surgeries but may not be possible, necessitating the other, more complex surgery.
Vasoepididymostomy--In this surgery, the vas deferens is attached to the epididymis, a coiled tube on the back of each testicle. Sometimes a vasectomy causes a blockage or break in the vas deferens or in the epididymis, and that is where this more complex surgery is useful. The vas deferens can be connected to the epididymus above the point of the break or blockage.
In general, the surgeon will not know ahead of time which surgery will be needed to restore fertility. In fact, it may be possible that you will require one of these surgeries on one side, and the other surgery on the other.
Some doctors use a general anesthesia for these procedures while other surgeons prefer to use a type of anesthesia in which you are not unconscious but feel no pain. Whatever anesthesia is used, your surgeon will want to make sure that you are immobilized during the delicate surgery, which is done by a microscope that magnifies the surgical area 5-20 times its size.