Success Rates of Microsurgical Vasectomy Reversal
The final proof of a successful vasectomy reversal is when a couple is able to experience the joy of holding their newborn baby in their arms.
When performed correctly, microsurgical vasectomy reversal is a procedure with an excellent success rate. Failures may be the result of technical aspects of the surgery itself, where the surgeon was not able to adequately reconstruct the delicate vas deferens and/or epididymis. By choosing a surgeon who has been trained in micro-surgery, uses an operating microscope and who will know how to diagnose- and deal with epididymal obstruction during the operation (see “Crucial Decisions during your Operation”), you can greatly enhance the odds of having a positive outcome.
Patency Rate vs Pregnancy Rate
Patency rate
A few weeks after reversal of your vasectomy, your semen will be analyzed to check for the presence of sperms. If they are found, it means that the operation was successful in restoring the continuity of the vas deferens – in other words “the canal” is open / patent again and flow of sperm from the testicle has been restored. The patency rate is a direct representation of the technical success of the surgery.
Pregnancy rate
Having sperm in your ejaculate after vasectomy reversal does not mean that your female partner will now definitely become pregnant. Many other factors determine this, most important of which is the age of the female partner. When looking at results of vasectomy reversal, the patency rate is usually higher than the pregnancy rate.
Factors that influence the success of vasectomy reversal and the ability of the couple to conceive:
Before Surgery
Obstructive Interval
This is the time delay between your vasectomy and the reversal procedure. The shorter this time, the better the success rates. The good news is that even if this interval is more than 10 – 15 years (and even > 20 years), with microsurgical techniques and a properly trained surgeon, there is still a good chance of success.
Age of the female partner
This obviously doesn’t affect the technical success of the vasectomy reversal surgery itself but is a strong predictor of pregnancy rates. The younger your female partner, the better the chance of her becoming pregnant after your vasectomy reversal.
Proven fertility of the male and female
There is a bigger chance of pregnancy if both you and your female partner have previously had children.
Previous failed vasectomy reversal
I have done done numerous repeat vasectomy reversals for patients who initially had their vasectomy reversal surgery elsewhere. My success rate for repeat vasectomy reversal is no different than for first-time operations. So even if a doctor had previously attempted a vasectomy reversal on you and it had failed, a proper microsurgical vasectomy reversal has more or less the same chance of being successful as in someone who has had no previous attempts.
During Surgery
Skill of the surgeon:
Results are much better with microsurgical techniques and in cases where your surgeon has been specifically trained in microsurgical vasectomy reversal.
Presence of sperm in the vas deferens fluid
If no sperms are seen under the 400X magnification microscope, it means that epididymal obstruction is present. In these cases it is completely useless to simply re-connect the vas deferens – the obstruction needs to be bypassed with a vaso-epididymostomy. Because this is a much more challenging procedure, success rates are not as high as for vasovasostomy.
Exact site of your vasectomy
The exact part of the vas deferens where a segment was removed during your vasectomy also influences the success of reversal. The closer this site is to the testicle, the bigger the chance of having epididymal obstruction, and requiring vaso-epididymostomy. This part of the vas deferens is also very thin, so surgery in this area is quite challenging.
The most important predictor of successful vasectomy reversal is the time that has elapsed since you had your vasectomy.
The last analysis of my personal data on more than 220 microsurgical vasectomy reversals, indicated a surgical success rate of almost 90% in men even 8 years after vasectomy and surgical success of more than 83% even if 13 – 15 years had passed since their vasectomy.