Procedure
A vasectomy is a fairly minor surgical procedure that involves severing of the sperm duct in order to cause male sterility. In the event that the patient wants to regain fertility, this procedure can be reversed. The vasectomy reversal can be done in the outpatient section of the hospital or it can be done in an ambulatory surgery treatment center. In either case, a surgical microscope is generally used to make visualization of the sperm duct easier. There are two main ways in which a vasectomy can be reversed: reattaching of the sperm duct, or an attachment of the sperm ducts to another structure, called the epididymis.
Vasovasostomy
A vasovasostomy essentially involves reconnecting the severed sperm ducts. Before the surgeon will perform this procedure, he or she will first take a fluid sample from the sperm duct to see if there is sperm present. If sperm is present (which indicates that the epididymis is not blocked), then the surgeon will stitch the sperm duct back together. According to the American Urological Association, the success rate for this procedure in restoring fertility is between 75 and 99 percent, with a future pregnancy success rate of between 30 and 75 percent.
This variability is due to the length of time between the vasectomy and its reversal---the greater the length of time between the two procedures, the less successful the reversal surgery is. In general, sperm return to the semen within 3 months.
Vasoepididymostomy
If the surgeon does not find semen in the sperm duct, this indicates that the original vasectomy caused a block in the structure that connects the testicles to the sperm duct. Consequently, the surgeon will need to bypass this blockage by connecting the sperm duct directly to the upper portion of the sperm duct, in front of the blockage. This procedure is more difficult and has a somewhat lower rate of success (the American Urological Association indicates that this procedure has a success rate of 50 to 70 percent with pregnancy with a female partner occurring 25 to 57 percent of the time). It can also take longer for sperm to return to the semen (between 3 and 15 months).
