Vasovasostomy is surgery to reverse a previous vasectomy. Although sporadically began to take place at the beginning of the last century, it was not until 1977 that it became popular thanks to Silber's description of his microsurgical technique.
Predictive factors of vasovasostomy success
Generally, there is a tendency to decrease the pregnancy rate as the years since vasectomy increase. Some authors consider that, especially above the age of fifteen, there was a significant decrease in this rate. However, percentages of about 40%. This is at least similar to the pregnancy rates per FIV-ICSI cycle (In Vitro Fertilization and Intracytoplasmic Sperm Microinjection).
The best results are obtained in men whose vasectomy was performed a few years earlier, as they can reach 80% if there is no problem in their partner. The experience of the surgeon and the realization of a careful technique is fundamental in this type of intervention.
Alternatives to vasovasotomy: FIV-ICSI
The development of new techniques of Assisted Reproduction allows us today to extract spermatozoa from the testis from a simple biopsy, and these can be used to perform an in vitro fertilization and sperm microinjection. Thus, vasectomized males may be able to have children again.
However, this involves a treatment of ovarian stimulation in women through hormonal injections, performing a lumbar puncture to remove the follicles, manipulation of the gametes in the laboratory to develop the embryo (the so-called baby-probe) and the Transfer of embryos to the mother. Therefore, it is a procedure involving both partners, there is a risk of multiple pregnancy and the pregnancy rate per IVF-ICSI cycle is lower globally than that of vasovasostomy.
The cost of an IVF-ICSI cycle, which includes biopsy and ovarian stimulation, often exceeds that of the intervention and sometimes several cycles are required.
Biopsy and an IVF-ICSI would be indicated in the following circumstances:
- Men whose partner is over 40 and / or have poor ovarian reserve.
- Men who only want temporary fertility, that is, once they have a child, they will repeat vasectomy.
- Due to technical difficulties or the failure of a previous vasovasostomy.
Recovery of fertility
Although the appearance of spermatozoa in the ejaculate can be immediate, it is generally necessary that at least two months pass for counting and mobility to be acceptable. However, this can sometimes take more than six months.
For more information about this, consult with a specialist in Andrology .