Reverse vasectomy

Bleeding after a vasectomy

Changes after vasectomy

Vasectomy

Will a vasectomy make me impotent?

Question

I had a vasectomy about seven years ago but I now have a new partner and wish to have children again.

If this is reversed, what are our chances of having another child?

Answer

Your situation is not uncommon. Around 10 per cent of men that have undergone vasectomy for sterilisation present to their doctor wanting the procedure reversed, in the hope that they will be successful in fathering children with a new partner.

Your chances of success after a reversal of vasectomy procedure depend upon:

For example, at Crawley Hospital, West Sussex, 85 men underwent vasectomy reversal between 1981 and 1994. All operations were performed without the aid of magnification.

A postal survey was sent to patients who could follow up, and among those who replied the pregnancy rate was 41 per cent (16/39 respondents).

These results are similar to those found by others performing reversal of vasectomy without the help of a microscope.

Following surgery for vasectomy reversal in the majority of cases, the cause for failure in achieving fertility is related to obstruction at the site where the ends of the tube that transport the sperm are joined. Further exploration to reconstruct the join using no magnification can be difficult and even impossible, and can result in further failure.

The outcome of revision by a microscopic technique has been investigated. Microsurgical treatment after previous failure provides further reasonable hope of success in becoming fertile.

In a further study, sperm in the ejaculate was achieved in 64 per cent of 22 patients operated on after previous failure. A follow-up of 23 months (range 8 months to 6 years) demonstrated a pregnancy rate of 27 per cent.

It would appear that a microscopic operation is the favorable procedure for vasectomy reversal for refertilisation as measured by overall pregnancy rates.

There is some evidence to suggest that once more than five years have elapsed since the original operation that the chances of refertilisation are reduced, but not impossible, so don't lose heart!

As you are seriously considering reversal, I would suggest that you discuss matters further with your GP and obtain a referral (which would probably be to the private sector) to a local fertility clinic.

In addition to the information I have given you, there is a need for you both to receive specialist counselling and advice on the techniques of assisted reproduction that might be necessary following the operative treatment.

Yours sincerely

Dr John Pillinger, GP

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