who’ve chosen the most permanent form of birth control—vasectomy—and
now want to have children should consider surgical reversal before they
pursue artificial conception methods, according to a University of
Cincinnati (UC) urologist.
so, says Ahmad Hamidinia, MD, could result in faster pregnancy and save
the couple thousands of dollars—not to mention the stress and
heartbreak of the multiple failed conception attempts that are commonly
associated with artificial methods.
vasectomy is an elective surgery to make a man unable to conceive
children (sterile). During the procedure, a surgeon cuts off and ties
the vas deferens, the tube that carries sperm from the testicles for
release through the urethra. Once this tube is blocked the man can only
ejaculate fluid devoid of sperm, eliminating the risk for pregnancy.
the National Institutes of Health estimates that one in six men over 35
choose to have a vasectomy, Hamidinia says that about 10 percent of
vasectomized men eventually seek reversal.
three Ds’—divorce, disaster and death—can put life into perspective and
often cause men who’ve had vasectomies to reconsider fatherhood,” says
Hamidinia, a professor and urological surgeon at UC. “The most common
reason my patients seek reversal is remarriage and the desire to have
children with their new partners.”
reversal—known medically as vasovasostomy—involves reattaching the
tubes that were cut during the initial surgery to reestablish sperm
flow. The procedure is done through small incisions on each side of the
scrotum using a microscope and specialized tools. It is performed under
general aesthesia and takes 1 ½ to 2 ½ hours. Patients can usually go
home the next day and return to normal activities—including sex—within
every man is a good candidate for this surgery, though, Hamidinia
cautions, because reversing the operation can be complicated and
involve more risks than the initial sterilization.
important to remember that it takes two to make a baby, so before a man
decides to have his vasectomy reversed, a physician should confirm that
he—and his partner—are fertile and physically capable of conceiving a
child naturally,” says Hamidinia.
couples who are capable,” he adds, “vasectomy reversal yields better
results for becoming pregnant and having a live birth than most means
of artificial conception. It also gives the couple the option to have
more children in the future, without additional costs.”
reversal costs about $7,000 (including physician, operating room and
anesthesia fees) and results in a 70 percent pregnancy success rate
compared with in vitro fertilization, which typically results in about
a 25 to 40 percent success rate and can cost up to $12,000 per
key factor influencing pregnancy success after vasectomy reversal is
the length of time that has elapsed between initial surgery and
who are more than five or six years out from their initial surgery are
more likely to have scar tissue from fluid build-up in the tubes where
sperm develops,” explains Hamidinia. “This causes irreparable damage
that has to be carefully bypassed before sperm flow can be
are alternative conception options for men who have had surgical
sterilization, including sperm extraction combined with in vitro
fertilization. This involves syringing sperm from the testicles, then
combining it with the female partner’s egg in the lab and injecting the
fertilized egg into the woman’s womb.
isn’t just about helping a couple get pregnant—it’s about managing the
emotions and expectations involved with having a child,” adds
Hamidinia. “A team of gynecologists and urologists can help the couple
make an educated decision about their fertility and choose what will
give them the very best chance to conceive a baby.”
For more information, visit www.netwellness.org, a collaborative health-information Web site staffed by Ohio physicians, nurses and allied health professionals.