Vasectomy Reversal

TODAY is Mother’s Day. In the United States, the celebration of Mother’s Day began in the early 20th century, and this is followed in various countries around the world, with the event most commonly observed around the month of March or May.

Throughout the world, Mother’s Day remains one of the biggest days for sales of flowers, greeting cards and long-distance phone calls.

Interestingly, churchgoing is also popular on this second Sunday of May, yielding highest church attendance after Christmas and Easter.

Although many may argue the over commercialisation of this special day has diluted the true meaning of maternal values, I still believe it is an important occasion to honour motherhood, maternal bonds and the overwhelming influence of mothers in society.

The famous author George Eliot once said: “Life began with waking up and loving my mother’s face.”

In the world faced with the issues of infertility, sadly, many women who battled with infertility may not even have the opportunity to nurture life and experience the miracle of motherhood.

On that note, I would like pay tributes to all the mothers out there, and spare a thought for others who are trying hard to become mothers when faced with issues of fertility.

Dear Dr G,

My name is Lucy. I am turning 40 this year.

I recently got married and am prepared to put my career on hold to start a family.

The problem is, my husband is 20 years older than me. He was previously married and has two children. He later had a vasectomy.

I would like to know how easy is it for my husband to have the reversal of vasectomy? Would his sperms still be healthy after 20 years of surgery?

Is it common for men to change their minds after the snip?

Will there be any risk of the reversal? Any complications?

How easy would it be for me to get pregnant?

Please help

Lucy

Vasovasostomy or the reversal of the vasectomy is an operation carried out to reconnect the male reproductive tract after the surgical interruption caused by vasectomy.

Although many doctors would lead patients to believe that vasectomy is a sterilisation operation that should be considered permanent, the advances in microsurgical interventions have allowed the reversal of vasectomy with improved successes in recent years.

As vasectomy is now gaining momentum to be a popular form of contraception due to its convenience, it is estimated between 40 and 60 millions individuals have had the surgery. This constitutes 5-10% of mode of birth control among couples.

Needless to say, with so many men having had the snip, some are bound to regret and change their minds in the future.

In the United States, about 5% of men later go on to have a reversal of vasectomy.

One study predicted the actual number of men inquiring about the reversal is significantly higher, however, many are put off by the complexity and the costs of the operation.

There are a number of reasons why men decide to reverse the vasectomy. The main reason is to start a family with a new partner following a breakdown in relationship or divorce.

In other situations, couples in long-term relationships may also change their minds after their financial circumstances improve or if their children are grown up and want to leave home.

The success of the vasectomy reversal is usually measured by two parameters: the patency rates and pregnancy rates.

In a recent study, 80-95% of men after the reversal will have motile sperms in the ejaculate within three months and one year following the procedure.

Despite the high patency success of the reversal, the overall pregnancy rates achieved is only around 55% if the reversal is done less than 10 years, and dropped to 25% over 20 years.

Many clinicians believed the low pregnancy rates after the long duration of vasectomy is due to prolonged “back pressure” that has damaging effects on the function of the sperms.

On the other hand, many men also developed anti-sperm antibodies that may impair fertility rates.

In reality, the single most important predictive factor in pregnancy is the female age. The pregnancy rate following any fertility treatments, including vasectomy reversal, falls significantly when the female age exceeds 40 years old.

Leonardo DiCaprio who paid tribute to his mother after winning the Academy Awards said: “My mother is a walking miracle.”

At the age of 40 and a partner with 20 years of obstructed reproductive tract, Lucy’s chances to experience the marvel of motherhood may seem remote.

Dr G’s advice to Lucy and her partner: Let the marvel of modern technology of In-Vitro Fertilization (IVF) and Intra Cytoplasmic Sperm Injection (ICSI) assist you to achieve the miracle of parenthood, with or without the reversal of vasectomy.

And of course, best of luck and wishes on Mother’s Day.