How Successful is a Vasectomy Reversal? Vasectomy Reversal Channel Ep2

Описание: Questions related to the success of a vasectomy reversal are common and very important. This episode of the Vasectomy Reversal Channel is dedicated to answering that question in detail.
Dr. Ethan Grober
Vasectomy Reversals Canada
https://vasectomyreversals.ca/

Hello and welcome Ethan Grober from Vasectomy Reversals Canada. So what is the success rate of a vasectomy reversal? Questions regarding the success of a vasectomy reversal are probably the most common questions I get. And not unlike the answers to most important questions, it depends. Success rates after a vasectomy reversal depend fundamentally on how you define success. Are we talking about sperm returning to the ejaculate, pregnancy rates, or the delivery of a healthy baby? They're all quite different endpoints. So, let's play this out. One measure of success is sperm. More specifically, the return of sperm to the ejaculate after a reversal. After a vasectomy, there should be no, none, zero sperm in the ejaculate. So, a successful reversal could reasonably be defined as the return of sperm to the ejaculate. This is where you might see some specialists claiming a 99.9% success rate. Truthfully, I think that's misleading. Return of sperm to the ejaculate is very important. It's the first critical step, but the devil is in the details. For example, a single dead or non-moving sperm in the ejaculate after a reversal could technically be defined as a success. Sperm are present in the ejaculate. However, the degree of sperm quantity or quality is very unlikely to result in a pregnancy or baby, which is ultimately what couples strive for. The presence of good concentrations of live, actively moving sperm in the ejaculate is a much more meaningful indicator of success. And the amount or concentration of moving sperm really needs to be measured in a reliable way at an experienced laboratory. In our experience, about 90 to 95% of men will have live active sperm returned to the ejaculate following a vasectomy reversal. But there's a caveat which I'll discuss in a bit. Okay. Now, the presence of live active sperm in the ejaculate is great, but achieving a pregnancy and delivering a healthy baby is the ultimate definition of success. In our experience, about two thirds of couples or about 60 to 75% are able to achieve a pregnancy following a vasectomy reversal. Even with the availability of good quality sperm, baby making is influenced by a series of complex factors. For starters, another person is entered into the equation, the female partner, and their age, overall and reproductive health, and egg quality are really important determinants of baby making. Relationship factors are also important. Some couples may try for a period of time then take a break or stop altogether and some relationships unfortunately don't last. Other important determinants of success are the training and experience of the surgeon performing the vasectomy reversal. Not only is their surgical proficiency and skill important but also their ability to exercise good judgment during the surgery to ensure the most appropriate and reliable reversal connections are performed. Technical factors are essential determinants of success with a vasectomy reversal. How the reversal was performed makes a big difference. Was it microsurgical or performed using a surgical microscope? Without question the gold standard or was it performed without the use of magnification? What type of reconnection was performed? Direct vastovaz recy connections or vaso vasostomytomy are the most reliable types of connections and generally result in live active sperm returning to the ejaculate in 90 to 95% of cases. However, sometimes direct connections are not indicated and a bypass connection is necessary also known as a vaso epidmostomy. If a bypass connection is required, we know that those connections are much more delicate and less reliable than direct connections. And we typically see live active sperm return to the ejaculate in approximately 75% of patients. That's the caveat I mentioned earlier. It's important to appreciate that depending on the training and experience of your surgeon, not all doctors performing vasectomy reversals are comfortable completing a microsurgical bypass connection or vasoepidmostomy and will only perform a direct vas to vas reconnection or vasovasostomy in all circumstances. Unfortunately, we know that if a bypass connection is indicated and not performed, it really compromises the success of the vasectomy reversal. All that to say that choosing a surgeon with the right experience is really critical to success. So back to the original question and to summarize things, what is the success rate of a vasectomy reversal? Ideally, couples should expect the return of live active sperm to the ejaculate in over 90% of cases. And with that, approximately 60 to 75% of couples are able to achieve a pregnancy following a vasectomy reversal. I hope this was helpful.