Men's one effective form of birth control is the Vasectomy. Normally vasectomy is considered permanent, but circumstances can change. Studies have shown that about 5% of men who've undergone a vasectomy choose to have it reversed down the road. It is possible through a vasectomy reversal to regain the ability to naturally conceive a child. A vasectomy reversal is also the most cost-effective way to have a child after a vasectomy compared to IVF and sperm retrieval.
Why get a vasectomy reversal?
Situations change over the years, but perhaps you have remarried and want to have children. As a couple, you and your spouse might have changed your mind and want more children. The common thought around vasectomy reversal is that it's an invasive procedure and potentially unsuccessful if it's been a long time since your vasectomy. That thought is incorrect, where a vasectomy reversal is quite successful and quick procedure at most intervals after the initial vasectomy.
How do you reverse a vasectomy?
The objective is to restore the flow of sperm into the ejaculate. The procedure is a relatively simple outpatient surgery that normally takes 2-4 hours. It includes finding the severed ends of the vas and putting back together under an operating microscope. This procedure is called the Vasovasostomy or Vas to Vas connection. During the surgery, the presence of sperm at the cut end of the vas deferens will be confirmed. If the fluid exiting the vas is good and contains moving sperm, a connection can be made. If no sperm is found, there might be a blockage closer to the testicles. If the Vas to Vas can't be made, the fertility doctor will choose to connect the vas deferens to the epididymis, the structure behind the testis that allows the sperm to mature. This second procedure is called the epididymal-vasectomy and is more complicated and often less successful.
Alternatives to Vasectomy Reversal
We also offer two alternatives to the vasectomy reversal procedure. The PESA (Percutaneous Epididymal Sperm Aspiration) or the TESA (Testicular Epididymal Sperm Aspiration).
Near the spot where the seminiferous tubules meet up to form the collecting system, there is a structure called the epididymis. The epididymis is a long, tightly coiled tube where sperm is stored and eventually transported to the vas deferens, which in turn, transports it to the outside world. The tightly coiled epididymis occupies much of the back of the testicle and is usually fairly easy to locate. A urologist can take a small needle and (with some anesthesia, of course) place it into the epididymis and aspirate a few droplets of fluid.
Because the blockage produced by the vasectomy takes place beyond the epididymis, sperm is still being produced in the testicle and stored in the epididymis. These few droplets of sperm will generally contain thousands (even millions) of sperm – enough for several in vitro fertilization procedures. The procedure to obtain sperm is called a percutaneous (through the skin) epididymal sperm aspiration, or PESA for short. It generally takes about 20 minutes to perform and the patient will walk quite normally afterward, with minimal recovery required. PESA is the most commonly performed of the vasectomy reversal alternatives. Sperm can also be obtained directly from the testicle in a similar procedure called TESE, which is more painful and has a longer recovery time.
IVF After a Vasectomy
While the sperm obtained through these techniques functions well for IVF, it generally has little motility and often lacks the ability to fertilize an egg on its own. For this reason, IVF with direct injection of sperm into the eggs is the method of choice for using sperm from PESA. Pregnancy rates with PESA-obtained sperm are not significantly different from those with normally ejaculated sperm.
The Fertility Center Reviews
"After working for over 10 years with OB/GYN doctors to try to conceive I finally reached out to a specialty clinic. I am so glad I did! They do things different and give you a lot more options. Just 3 months after working with these great doctors I became pregnant. Now, we are parents to the sweetest little boy. Thank you Dr. Donesky and Dr. Bird for listening and caring for me. Your staff is wonderful also and genuinely cared about my husband , myself and our dreams of becoming parents. God Bless you all!!!" - Amber
"LOVE the fertility center of Chattanooga. Professional & very friendly. Immediately made us feel comfortable. Excellent, competent & affordable care, worth the drive from Alabama. Our son was conceived on first round of IUI. Forever grateful to Dr. Donesky & Dr.Bird and all the wonderful staff." - Laura
"I went for my first consult with Dr Donesky. He was very knowledgeable and understanding. His explanation of things such as medicines and answering questions was excellent. The atmosphere in this clinic is so warming. The ladies that work here absolutely love what they do and it sure does show!!! The email and phone call return for the staff is excellent!!!! If you have a question it is always answered in a wonderful time frame, my questions have always been answered the same day that they were asked. Infertility is a very emotional thing and couples need support, the staff in this clinic are so supportive and loving. Im from the central Arkansas area and I traveled 8 hours there and 8 hours back to go to this clinic and I would do it all over again! It was worth every single second of travel time. If you are "shopping for a fertility clinic family" this clinic is a great invest!!! Dr Donesky ROCKS and the ladies are awesome!!!!! Good luck and baby dust!!!!!" - Chelsa
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"I treated at the Fertility Center office in Knoxville, and I cannot say enough good things about this practice. Having been to most of the fertility practices in Knoxville, I can honestly say that this is a unique medical practice. Everyone there is so compassionate, and they truly take into account the situation you are in with every interaction. Dr. Donesky has a real gift with infertility, and we wouldn't be expecting our twins without him. I strongly recommend him and this practice to anyone facing fertility problems." - Sarah