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Vasectomy reversal — there’s still time

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Posted at 4:03 PM, Jun 19, 2015
and last updated 2015-06-23 18:14:28-04

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The following article is sponsored by University of Utah Health Care.

You thought your baby-making days were over so you had a vasectomy, but now a new marriage or other life circumstance has you yearning to be called daddy. It’s not too late. More than likely, you can become your fertile old self once again.

Vasectomies can be reversed in 90-95% of cases, said James Hotaling, M.D., a urologist at University of Utah Health Care. In fact, 6% of men who undergo the procedure ultimately decide to undo it.

In most cases, it’s a matter of reconnecting the previously severed vas deferens, the pair of tubes that transport sperm from the testicles to the ejaculatory ducts.

“In the simpler version of a vasectomy, called a vasovasostomy, we make a small incision in the scrotum, and using a microscope, we go in and find the area that’s been clipped, and then we put the two areas back together,” Hotaling said.

Men who receive a vasectomy are cautioned that the surgery is a permanent form of birth control that is not always reversible. But why? It’s usually about timing. The more time that has elapsed since the procedure, the higher the likelihood that blockages like scar tissue can form and cause an obstruction, Hotaling explained.

“A vasectomy is easiest to reverse in the first 10 years,” Hotaling said. “But you never fall off a cliff; your chances of a successful vasectomy level off after about a decade and remain high. More than 90% of men who are 10 years or more removed from a vasectomy can still get it reversed.”

If the surgeon discovers that the vas deferens can’t be reattached through a vasovasostomy, he or she can use a more complex technique, an epididymovasostomy, to restore sperm flow.

“In this procedure, we attach the vas deferens directly to the epididymis, which is the small organ that holds the sperm and is located at the back of each testicle,” Hotaling said.

Prior to a vasectomy, the surgeon won’t know which technique will be needed, Hotaling said. During the procedure, a doctor will check for sperm inside the vas deferens. If there is no sperm inside the tubes, there may be a blockage, and an epididymovasostomy may be required.

70% of vasectomy patients are able to go the vasovasostomy route while the other 30% need an epididymovasostomy, Hotaling said. The technique used won’t affect the patient since both require the same number of sutures (10-16 stitches each smaller than a human hair) and the same length of recovery (10-14 days of taking it easy and 5-7 days with no heavy lifting).

After a successful vasectomy, a man will become fertile again in 8 weeks to 18 months. In the rare chance that the vasectomy reversal is not successful, a man who produces sperm can still become a father through an in vitro fertilization procedure called intracytoplasmic sperm injection in which a single sperm is injected directly into an egg.

“There are a lot of options for men who wish to become a biological father after undergoing vasectomy,” Hotaling said. “Men sometimes think it’s too late and are surprised to learn it probably isn’t.”

So, if you’ve had a vasectomy but find yourself pining for daddy-daughter dates, Little League coaching, and experiencing the precious paternal bond of a father and his child, a vasectomy reversal is a very real option — even if you got snipped many years ago.