September 2003
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Ten percent of men change their mind after a vasectomy
One-tenth of men who get a vasectomy change their minds later, said a professor of urology at Baylor College of Medicine in Houston.
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| Larry Lipshultz, MD, views patient chart |
“This is most commonly because of remarriage,” said Larry Lipshultz, MD. “Vasectomy reversals are also requested by couples who have merely ‘changed their minds,’ as well as by couples who have lost a child and are attempting to initiate another pregnancy.”
Following a divorce and remarriage, Houstonian Steve Bass visited Lipshultz 14 years after having had a vasectomy.
"(My wife and I) just sat down and talked about it, and we wanted to see what we could do about having a child together,” he said. "I've always wanted a houseful of kids. I would have four, or five, or six if possible."
The only way to achieve the family he wanted naturally was to have his vasectomy reversed.
During the delicate procedure, surgeons find the two ends of the vas deferens and free them from the scar tissue. The vas deferens is one of the tubes or ducts that carry sperm from each of the testis to the ejaculatory duct. Once it’s determined that the fluid in the vas contains sperm, the two ends are sutured together, thus reversing the vasectomy. The operating time is usually around three hours, said Lipshultz.
Sperm banking is routinely performed at the time of vasectomy reversal
if whole sperm are present. Cryopreservation, or freezing the sperm, is
performed as a backup in case inadequate sperm counts are present after
surgery.
However, not every vasectomy is reversible, he said.
“When the vas is opened, fluid will flow from the testicular side of the vasectomy site,” said Lipshultz. “If sperm are present, then we expect most patients to demonstrate a return of sperm with an associated 60 to 70 percent pregnancy rate. If no sperm are present, yet the vasectomy fluid looks abundant and appropriate for ultimate sperm production, then the reversal is performed with a successful outcome in approximately half of all patients.”
If poor-quality fluid is present and sperm are absent, or no fluid at all is found, then a procedure called an epididymovasostomy (connection of the vas to the epididymis, or the chord along the border of the testes that provides storage and transport of sperm) is performed with a successful outcome of approximately 40 to 50 percent. Following the procedure, there is a brief period before conception is possible.
"I tell couples who are having reversals not to expect it right away because it takes time for these very small tubes to become un-inflamed and open up," said Lipshultz.
In Bass’ case, the procedure was successful, and produced results quicker than expected.
"We were told that it would take anywhere from six months to a year before anything would happen,” he said. “So, we were quite surprised when two months after the surgery, she (Bass’ wife) came home and said she was pregnant. It was somewhat of a miracle actually."
At age 47, Bass says there is nothing in life that compares to rocking his new daughter, Emma, to sleep.
"Oh it's amazing. Just amazing,” he said. “I just never thought I would have that opportunity again. There are certainly no regrets with having the procedure reversed. I'd do it again in a heartbeat."
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