A vasectomy is a relatively simple and very effective surgical procedure to prevent pregnancy. Although a vasectomy is considered permanent and is generally performed on men who have already had children and do not intend to have more, there are situations that may motivate a man to want to have the procedure reversed. Studies show that 1 to 5 percent of men who have had a vasectomy choose to have a reversal In the Sacramento area, Northern California Fertility Medical Center uses the most advanced technology and methods to reverse vasectomies and restore fertility. The following text is a brief summary of key issues related to vasectomy reversal.
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How Is a Vasectomy Reversal Performed?
There are two procedures that may be used to reverse a vasectomy. The standard procedure, known as a vasovasostomy, is a simple reconnection of the severed ends of the vas deferens, which carries sperm from the testes to the ejaculatory duct.
If, however, the epididymis has become blocked, then this standard vasectomy reversal procedure is unlikely to be effective. At our Sacramento area practice in Northern California, we assess the fluid collected from the end of the vas deferens that is closest to the testis. The fluid is examined with a microscope and its gross (non-microscopic) quality is assessed, and this gives us clues about whether or not the epididymis has become blocked. If the fluid is watery and live or dead sperm are seen under the microscope, the chance of getting sperm back from the standard vasovasostomy procedure is over 90%. If the fluid is thick and free of sperm cells, then the chances of a successful vasovasostomy procedure are only about 10 percent. In such a case, a vasoepididymostomy will be performed instead, increasing the potential for the return of sperm cells to 75 percent.
Sometimes an examination of the fluid is inconclusive. When this occurs, Dr. John E. Gould, a urologist and male infertility specialist, will assess all relevant factors and perform the type of reversal that has the highest chance of success. Under certain conditions, he may perform both procedures, using a vasovasostomy on one side and a vasoepididymostomy on the other.
Vasovasostomy
The standard procedure for a
vasectomy reversal, a vasovasostomy involves the reconnection of the vas deferens by cutting above and below the damaged segment and carefully stitching the two fresh ends back together. Dr. Gould uses an operative microscope and performs a "three-layer" connection. This technique requires significant surgical skill but results in an extremely precise and stable connection.
Vasoepididymostomy
If a vasoepididymostomy is necessary, the vas deferens will be connected directly to the epididymis. This allows the blockage in the epididymis to be bypassed, significantly improving the chances of successful restoration of fertility in men with this condition. However, a vasoepididymostomy is somewhat more delicate than a standard vasectomy reversal, so it is only performed when there is significant evidence that the vasovasostomy procedure is unlikely to be successful. Dr. Gould performs an average of one vasoepididymostomy for every 10 to 15 vasovasostomies. The longer it has been since the vasectomy, the more likely it is that a vasoepididymostomy will be required.
Success Rates
There are several ways to measure the outcome of a vasectomy reversal procedure. Physical reconnection of the vas deferens, return of sperm cells to the ejaculate and initiation of pregnancy in a woman are examples of appropriate outcome measures. Physical connection of the vas is virtually guaranteed, and return of sperm cells depends on the number of years since vasectomy. Pregnancy rates depend on the quality of the semen and the age of the woman. There is no substitute for experience, and Dr. Gould performs 150 to 200 reversals per year. Our Sacramento area practice in Northern California has attracted patients from all over the U.S., and we would be happy to provide you with an affordable surgery by a highly experienced surgeon.
Cost
We are currently able to offer one global fee for vasovasostomy (vasectomy reversal) or if necessary vasoepididymostomy (correction of epididymal obstruction). The total fee is $6800.00. This global fee covers all aspects of the reversal including the “pre-op”, surgeon fees, facility fees and anesthesia fees. Dr. Gould will check semen samples after surgery for the presence of sperm cells for no charge. The global fee does not cover an option to freeze sperm cells during surgery, and you may wish to discuss this option with Dr. Gould.
Most of our patients find that their insurance company will not pay for the reversal. You may wish to submit a claim to your insurance company and we would be happy to assist you.
We are extremely proud that this global fee is much lower than comparable fees around the United States. Other programs offer this same arrangement for up to $25,000.00. Remember that this global fee will cover not only a bilateral vasectomy reversal but will also cover the more delicate correction of epididymal blockage if it is found. The $6800.00 global fee is due no later than the day of surgery.
Please call Dr. Gould at (916) 773-5529 if you have any questions about the microscopic vasectomy reversal program, and he will personally return your call. There is no charge for a phone consultation.
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