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A Second Chance: Vasectomy Reversals

They’re expensive and complicated, but vasectomy reversals may be worth it for men who want a second lease on fatherhood.

A Big Decision continued...

A vasectomy prevents the release of sperm when a man ejaculates. During a vasectomy, the vas deferens -- the tube that carries sperm from the testicle -- is cut or clamped. After a vasectomy, the man still ejaculates, but the semen contains no sperm. In a vasectomy reversal, the vas deferens is sewn back together or attached directly to the testicle so sperm can once again enter the semen.

Vasectomies are relatively simple procedures that are nearly 100% effective. By contrast, a vasectomy reversal requires use of surgical microscopes and microscopic sutures. And vasectomy reversals usually aren’t covered by insurance. The cost can vary strongly depending on the surgeon, but Marks estimates that it ranges between $8,000 and $20,000.

Before conducting the procedure, Marks consults with the man’s female partner to try to increase the chances that she is fertile. If the woman is over 35 or has menstrual irregularities, he suggests that she visit a reproductive endocrinologist to investigate fertility issues. “There’s nothing worse than investing financially and emotionally [in a reversal] and finding out that there’s no way the female partner can conceive,” Marks tells WebMD.

In Marks’s surgical suite, the reversal procedure typically takes about three hours. McCroskey remembers making jokes throughout the procedure as he felt the effects of laughing gas. The aftermath was somewhat more painful -- McCroskey’s privates were packed in ice for much of the time. “I remember thinking, vasectomy’s got nothing on this,” he says.

A Tale of 2 Procedures

The success rate of vasectomy reversals is generally related to the length of time that has elapsed since the vasectomy performed. That’s because men who had vasectomies a long time ago are more likely to require a more complex and challenging form of reversal procedure.

In the most common form of reversal, the surgeon simply sews together the severed ends of the vas deferens. But in some cases, blockages have formed in the vas deferens or the tube between the vas and the testicle, known as the epididymis. In that case, the vas deferens must be directly connected to the epididymis. This procedure is known as a vasoepididymostomy, or “VE.”

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