Normal Fertility
A very important issue to consider when assessing pregnancy rates from vasectomy reversal is that of normal fertility rates. When reading of extravagant claims made elsewhere on the Internet about baby rates following vasectomy reversal it is important to be aware that the normal chance of a young couple (female age under 30 years) of successfully achieving a pregnancy within one year of starting to attempt to do so is 85%. For the average couple trying to achieve a pregnancy (female age >30 years) the chance of pregnancy is 80% in the first year of trying to do so.
There are those who claim pregnancy rates following vasectomy reversal that exceed normal fertility rates. It is not possible to produce pregnancy rates greater than the normal chance of pregnancy of a fertile couple. Claims that pregnancy rates following vasectomy reversal exceed 80% - thus making the claim that it is possible to improve on normal fertility - should be viewed with considerable suspicion.
Beware of statements of ‘success rates’ that represent the presence of sperm and not successful pregnancy. There are many that simply claim their ‘success rate’ without stating whether this represents patency or pregnancy. If this is not made clear you should assume this represents patency and not pregnancy.
Patency Rates
Technical success from microsurgical vasectomy reversal is excellent. Over 95% of men who have undergone vasectomy reversal by me and have had follow up semen analysis have sperm in the semen.
As mentioned above, there is however a real and important difference between technical success, as measured by sperm being present in semen and practical success, as measured by pregnancy.
Pregnancy Rates
For the average patient under going microsurgical vasectomy reversal under my care the overall postoperative pregnancy rate is high at 50% to 80%. Your personal probability of achieving a successful pregnancy is dependent on a number of factors; the most important of which are:
- The duration of time since vasectomy
- Your partner’s age
The greater the time since the vasectomy, the lower the chance of a successful reversal. This is due to back pressure effects on the testis causing damage to sperm production. In addition the very fine tubules (epididymis) just next to the testis develop damage from this pressure and they often break open and then scar over so that there is a second blockage very close to the testis.
- Less than 4 years since vasectomy: 75% to 85% achieve pregnancy
- 4 to 8 years since vasectomy: 55 % to 75% achieve pregnancy
- 9 to 15 years since vasectomy: 40% to 60% achieve pregnancy
- Greater than 15 years since vasectomy: 20 to 40% achieve pregnancy
If sex fails to achieve a pregnancy all is not lost. As most men have sperm in their semen these can be concentrated artificially and used for either intra-uterine insemination or In Vitro Fertilisation. The advent of the technique known as Intracytoplasmic sperm injection (ICSI) has dramatically improved pregnancy rates for those who fail to achieve pregnancy normally or who have very low sperm numbers or motility following the reversal.
Take Home Baby Rates
It is wise to take into consideration that as a result of the occurrence of miscarriage that "take-home-baby" rates will be less than pregnancy rates. The most important factor influencing the chance of miscarriage is also female age - the older your partner the higher the chance of miscarriage.
The single most important factor influencing pregnancy rates and take home baby rates following vasectomy reversal is female age.
The older your partner's age the lower the chance of successful pregnancy.