Male Fertility
What is a Vasectomy Reversal?
There are two procedures that can be performed to 'reverse' the blockage caused by a prior vasectomy. These are a vasovasostomy and vasoepididymostomy. Use of an operating microscope has been documented to provide the best success rate. A microsurgical vasovasostomy is the reconnection of the two severed ends of the vas deferens (as shown below). The vas deferens is the conduit for sperm to travel from the testis to the urethra. This is the preferred procedure and offers the best chance of sperm returning to the ejaculate and subsequent pregnancy.
A microsurgical vasoepididymostomy (VE) is the connection of the end of the vas deferens to the epididymis. This is a more extensive procedure and is performed when there is a congenital blockage of the vas deferens or when sperm does not flow from the opened end of the vas deferens at the time of reconstructive surgery. A VE will always be performed if required.
Are there ways to obtain sperm other than a vasectomy reversal?
Yes, several ways! These involve taking sperm from either the open end of the vas deferens, from the epididymis (MESA; Microsurgical Epididymal Sperm Aspiration) and from the Testes (TESE; TEsticular Sperm Extraction). Sperm retrieved in this manner can be cryopreserved (sperm banked) for future use. This can be done at the time of a vasectomy reversal or as a separate procedure. Sperm retrieved in this manner can only be used with In Vitro Fertilizartion (IVF) proceudres. This is because of the low number and decreased motility (movement
Training, experience and technique is extremely important to the success of the procedure. However, the cause of the blockage (e.g., vasectomy, infection or trauma) and whether a unilateral (single side) or bilateral (both side) connection can be made is also very important. Your particular situation might affect your results. This is one reason why the consultation prior to the procedure is so important - to give you the realistic 'success rate' for your particular situation.
