Children are precious little balls of love and energy. So it’s little wonder that parents may decide that they’re completely done having children, only to change their minds later.
As a urologist, I support patients with a variety of health concerns, but vasectomy reversals are one of my favorite parts of my practice. Helping people make babies—whether because they want a bigger family or they have a new partner—is hopeful and fun. Plus, the results are pretty adorable.
If you or your partner are among those whose dreams for their family have changed, then a vasectomy reversal may be a good option. It’s more cost effective than trying in vitro fertilization, and has a higher success rate.
What the operation is like
The reversal procedure itself is straight-forward, yet delicate. Working under a microscope, a doctor uses a suture the size of a strand of hair to reconnect the sperm-carrying vas deferens. It takes an hour to three hours to complete the procedure. Most men can return to light activity within a week and resume their normal activities in a few weeks.
The worst part is probably the requirement to wear a jockstrap for five weeks while the stitches heal. Men also need to wait at least three weeks before resuming sexual activity. At the five-week mark, and every three months thereafter, doctors test for the presence of sperm to confirm that pregnancy can occur.
Success rates for reversals
Reversals are highly successful in men who have had a vasectomy for less than 10 years. In fact, 70 percent of men in this group go on to have a child. Success for men whose vasectomy was 10 to 15 years ago is slightly lower. About 50 percent of them go on to have children. The older the vasectomy, the more time the tissue of the vas deferens has to scar or fall apart.
As the only provider of vasectomy reversals in Clark County, I perform 20 to 30 reversals a year, which is high compared with national rates. So far, 100 percent of my patients have had sperm return. One of my patients recently shared that he’s having twins!
For patients who have had a vasectomy for more than 15 years, or who will need a more complicated surgery, I refer them to a colleague at OHSU who specializes in complex cases.
How much it costs
Oftentimes, price can be the biggest concern for couples. Insurance companies consider reversals to be a cosmetic procedure and don’t provide coverage. That means the whole thing is generally paid for out of pocket. At The Vancouver Clinic, reversals usually cost $5,900. This covers the surgery space at the hospital, general anesthesia, and the procedure itself.
Innovations in male birth control
While I enjoy helping families expand, I look forward to the not-so-distant future when men have more non-surgical options for controlling fertility: A new polymer gel, which is injected into the vas deferens and can destroy sperm for years, is nearing regulatory approval. The gel itself can be eliminated with a second injection, resuming fertility. Another device that can flip access to sperm on and off with a switch is also under development.
However, until those innovations make it to the U.S. market—and even when they do—vasectomy reversals will remain an important option for couples. If you have more questions about reversals, I encourage you to make an appointment to learn more.
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Dr. Adrienne Heckler is a urologist at Vancouver Clinic. She employs advanced microscopic and robotic skills to provide excellent care for patients, and is also an expert in urologic oncology.
