Vasectomy Reversal: Things You Should Know

Vasectomy should be considered a permanent procedure.

Although it should be considered permanent, many patients are aware vasectomy reversal is possible. Many vasectomy providers will inform patients vasectomy is permanent but many of these same providers will also advertise they perform vasectomy reversal and their procedures are highly successful. To me this presents a discordant message and this is why I believe vasectomy reversal should be better discussed when considering vasectomy.

If regret is the most common risk of vasectomy then it stands to reason the most common treatment sought as a consequence of vasectomy regret should be better discussed.

I believe this topic deserves more than just a ‘vasectomy is permanent’ message to potential vasectomy patients. Some patients may believe vasectomy reversal is as simple as unconnecting and reconnecting a garden hose. It is not that simple and understanding why may better help you understand why vasectomy should be considered permanent.

Success of vasectomy reversal

Although many reversal experts want you to believe it is their skill, expertise, and technique that are the most important factors in vasectomy reversal success these factors are not the most important predictors of reversal success. The single most important predictor of vasectomy reversal success is the length of time that has elapsed from the vasectomy to the time the vasectomy reversal is performed.

If reversal is performed:

• within 3 years of vasectomy the reversal is successful 97% of the time
• within 3 to 14  years of vasectomy the reversal is successful 91% to 82% of the time
• greater than 14 years after vasectomy the reversal is successful 69% of the time

One can easily see that reversal success rates are fairly good but reversal success rates are not 100% in every case.
This is why vasectomy should be considered permanent.

Why is time important in vasectomy reversal success?

After the vasectomy is performed the downstream end of the vas deferens will often experience higher pressures since the free flow of sperm has been blocked. This can cause either sudden or gradual disruption in the epididymis. This disruption can cause inflammation and inflammation can cause the epididymis to either stop producing sperm, produce sperm in lower amounts, or produce dysfunctional sperm.

I perform an open-ended vasectomy. Although debatable, open-ended vasectomy is thought to cause less epididymal inflammation, less pain, and is more reversible. Even with an open-ended vasectomy reversibility is not 100%.

Immunizing yourself against sperm

Your own sperm is actually a foreign and unrecognized substance to your body because it is carefully contained inside its own protective system. Your body’s immune system never recognizes the sperm are there. When you have a vasectomy it exposes your body to sperm and some men will create antibodies (an immune response) to their own sperm. Although how much of an effect anti-sperm antibodies have on sperm production and infertility is debatable, there has been observed impairment of fertility in some men who have these anti-sperm antibodies.

When you have a vasectomy some men may be vaccinating themselves against sperm. This is not harmful to a man’s overall health but could impair future fertility and this is another reason why vasectomy should be considered permanent.

Vasectomy reversal: Its expensive

Vasectomy is often covered by health insurance. Vasectomy reversal is not covered by health insurance.

Many men will only have to pay a small co-payment when using health insurance. Even if one has to pay the entire amount of the cost of vasectomy, vasectomy reversal will cost much, much more. Health insurance will not pay for vasectomy reversal…no matter what the cause or what the reason is for the reversal.

The average cost for vasectomy reversal ranges from $9,000 to $18,000 . Vasectomy reversal is not cheap. For some men vasectomy will be permanent but only because of financial reasons.