Recovery after a vasectomy
The decision to undergo a “vasectomy reversal” is made by men in new relationships or changed plans; the chances are higher if the period after vasectomy is up to 10 years and the presence of sperm in the fluid from the duct during surgery. Both sides are reconstructed sequentially; if the appendage is impassable on one side, an epididymovasostomy is performed there - the surgeon decides this intraoperatively. During surgery, sperm can be stored for cryopreservation in case of failure. The result is assessed by spermogram throughout the year; restoration of patency may take up to 6–12 months.
Obstructive infertility
If the testicles produce sperm (normal testicular volume, normal FSH, spermatogenesis according to biopsy), but there are no sperm in the ejaculate, the reason is an obstruction in the vas deferens: after a vasectomy, previous epididymitis, trauma, surgery on the inguinal canal. Microsurgical reconstruction restores natural patency and allows conception without IVF; effectiveness depends on the level and duration of obstruction.
Results
After vasovasostomy, sperm appear in the ejaculate in 75–90% of men up to 10 years after vasectomy; pregnancy in couples occurs in 40–60%. After epididymovasostomy, patency is restored in 60–80%, pregnancy in 30–40%. If reconstruction fails or is not possible, sperm are obtained from the testicle (MESA/TESE) for IVF-ICSI; During surgery, the surgeon can prepare them for cryopreservation.
