Vasectomy Reversal is a procedure which allows men who have previously undergone vasectomy to become fertile again. The vas deferens is microsurgically reconnected and the epididymal blowouts are microsurgically bypassed, allowing sperm to travel out of the epididymis and into the ejaculate.

Vasectomy reversal is a complex topic. I had a reversal for chronic post-vasectomy pain and it was successful in relieving the pain and also successful in returning fertility.

The outer diameter of the vas deferens (sperm duct) is about 1/8 of an inch, but the diameter of the inner canal which carries the sperm is about 1/70 to 1/100 of an inch, or roughly the size of a pinpoint. This inner canal has a lining of mucosa which is about 3 cells thick. In order to achieve a non-obstructed reconnection, it is necessary to accurately stitch this inner lining in a leakproof fashion, using thread that is invisible to the naked eye (approximately 1/1000 of an inch in diameter). Then the relatively thick muscular wall (1/16 of an inch on each side) is similarly stitched to insure proper muscular contraction for moving sperm into the ejaculate.
This is all performed under a microscope with very high magnification, using delicate instruments and suture designed specifically for this surgery.

The epididymis is a coiled, 20-foot long, fragile, microscopic tubule that carries sperm from the testicle into the vas deferens. The delicate wall of this tubule is a thin, filmy membrane 1/1000 of an inch in thickness. The diameter of the tubule is 1/300 of an inch, or roughly 1/3 the size of a pinpoint. After vasectomy, the testicle continues to produce sperm and fluid normally. This causes a build-up of pressure within the vas going all the way back to the epididymis. In most individuals this pressure causes a "blow-out" in the epididymis, similar to a leak in the thinnest part of a tire that has more pressure than it can handle. Sperm then leaks into surrounding tissue and causes scarring and obstruction.

The majority of vasectomized men have such epididymal blow-outs. The longer the duration of time since your vasectomy, the greater the chance that you will have epididymal obstruction. However, it is important to understand that epididymal blow-outs can occur anytime following your vasectomy. If this has happened to you, these blow-outs will need to be repaired at the time of your reversal to maximize your chance of regaining fertility.

Sperm counts do not reach normal values until 3 to 8 months after the reversal operation. This is the time required for recovery of sperm transport mechanisms. Sometimes sperm recovery requires longer however, and the uncertainty surrounding such a wait is usually less emotionally traumatic when you know that a technically perfect repair has been performed.

In patients with no epididymal obstruction, 98% develop normal sperm count and sperm motility, indicating fertility. 88% achieve pregnancy without further treatment.

For anyone who has had a vasectomy, or even one or more previous failed vasectomy reversals, the simplest, most cost-effective approach, as well as the best chance for a pregnancy would still be to reconnect the ducts microsurgically. This involves no greater surgical discomfort than the sperm aspiration and gives a 95% chance for a successful return of fertility, as compared to a 40% pregnancy and delivery rate per treatment cycle with sperm aspiration and ICSI. However, by having the ICSI option available as backup, you have virtually a 100% chance of success so long as the wife is fertile. Therefore, make sure they offer you the benefit of both vasectomy reversal and ICSI.

Don’t listen to lay people on this one. Do your own research.

Sorry that yet another person that does not even know what a vasectomy is, was posting nonsense (above). Too bad they can’t take away points for that. It amazes me the number of uneducated people that don’t know that a vasectomy does not include cutting off anything.

You will not hear of very many successes. The reason is complicated. But the skinny is, that doctors claim high "success" because legally they can claim success as long as live sperm are found in the man’s semen within two years after the surgery. That is why they claim 80-90% success. The truth is, the sperm is usually too weak to be of any use. That is a fact. In almost every case IVF was needed after the reversal.