There is no doubt that the most important issue that you should take into consideration is the skill and experience of the surgeon who performs your vasectomy reversal. Dr Robert Woolcott is a full time fertility specialist who concentrates on reproductive microsurgery and as such I am continually performing vasectomy reversal procedures. In addition, he has a dedicated surgical team who exclusively assist him in performing vasectomy reversals. The same staff doing the same procedures, all of the time, means maximum expertise and experience available to you.
Achieving a pregnancy is obviously by far the most common reason for wishing to have a vasectomy reversal - but it is not the only one. Long-term pain following prior vasectomy, while uncommon, does occur (so called Post-Vasectomy Syndrome). Vasectomy reversal has a greater than 70% chance or relieving or reducing such pain and is a worthwhile indication. On the other hand there is no evidence that physical sexual dysfunction is caused by vasectomy - so reversal will have no beneficial effect.
The single most important factor influencing the prospect of successful pregnancy following vasectomy reversal has nothing to do with the surgery itself or for that matter the man undergoing vasectomy reversal. It is the your partner's age.
Obviously the older you are the more likelihood that you may have some additional medical problem that may influence the safety of surgery or the chance of complications. In addition, many people will think about the difference in age between parent and child as they get older.
It is important to be aware of your general state of health prior to any surgical procedure. There are a variety of conditions that may affect the outcome of your operation. In particular any trauma, infection or disease involving the scrotum, penis, prostate gland or pelvic organs. Cardiovascular, respiratory and neurological disease may also be of major significance for your anaesthetic. Smoking has been shown to reduce fertility by affecting sperm function as a result of toxins. Please ensure that I am made fully aware of your past medical history at the time of your pre-operative consultation.
Provided that you are in good general health, no specific or unique testing is required prior to your operation.
In particular, there are some who suggest that pre-operative scrotal ultrasound is of benefit in planning vasectomy reversal. This is simply incorrect. The only way to accurately assess whether microsurgical vasectomy reversal is feasible is to surgically explore the scrotum. In this context ultrasound is a waste of time and money, as fortunately, with or without pre-operative ultrasound, it is technically possible to microsurgically reanastomose both vas deferens in more than 99% of cases.
Sperm antibodies are produced after exposure of sperm to the immune system. About 60% of men develop sperm antibodies in their blood following vasectomy. It has been proposed by some that the presence of high-level sperm antibodies may reduce pregnancy rates following vasectomy reversal. However, the presence of sperm antibodies in the blood is not closely associated with pregnancy following reversal and so the value of testing for sperm antibodies pre-operatively is both controversial and unproven. There are many other more important factors listed here.
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