Microsurgical Vasectomy Reversal
Robert U. Finnerty M.D. FACS
Microsurgical Vasectomy Reversal
Robert U. Finnerty M.D. FACS

Pregnancy Rates Following Vasectomy Reversal

Pregnancy rates are dependent on a number of factors. First, there is generally a decline in technical success rates — due to the increasing need to perform more complex and difficult epididymal repairs — as time from vasectomy increases. More importantly, pregnancy rates also decline because sperm quality and fertility tend to deteriorate progressively with time after vasectomy, due to the effects of chronic obstruction on the epidiymal duct system. These changes often result in larger numbers of sperm which have poorer motility and decreased ability to penetrate and fertilize the egg.

Decreased fertility with increasing patient age may also play a role. Traditionally, the pregnancy rates (i.e., the percentage of couples able to achieve pregnancy) for reversal surgery in most studies has been approximately the following:

Vasectomy Reversal Pregnancy Rates
Years After Vasectomy % Pregnancies
1 to 5 years 60 to 70%
6 to 10 years 40 to 60%
11 to 15 years 25 to 40%
Over 15 years 15 to 25%

These historical pregnancy rates are somewhat dated because of progress in surgical techniques and decision-making, however. In his nearly 40 years experience with reversal surgery, including a large number of epididymal reconstructions, Dr. Finnerty has observed several interesting trends. First, in patients undergoing successful epididymal repairs, pregnancy rates were surprisingly good — even when patients were many years out from vasectomy. Second, when the epididymis was explored in men in whom epididymal obstruction was present, sperm quality in the proximal epididymis (closest to the top, near the efferent ducts where the sperm leave the the testes) was excellent, with a high percentage of active sperm, while sperm in the mid- and distal epididymis (farther from the top of the testes) was often non-motile and of poorer quality. Third, when men without epididymal obstruction had poor-quality sperm at the vasectomy site, their surgery was usually technically successful (reasonably good sperm counts afterwards), but pregnancies were relatively rare and low sperm motility was common. These findings have also been noted by Dr. Sherman Silber, one of the pioneers in microsurgical reversal surgery. This, and susequent research on the function of the epididymis, indicate that the epididymis develops abnormal function as a result of obstruction, and in many men, epididymal repair will improve pregnancy rates, even when complete epididymal obstruction is not present, but is only partial.

The main barrier to using these findings to achieve better pregnancy rates has been the ability to perform epididymal repair with high technical success rates. The extremely delicate nature of the epididymal tubule requires extensive surgical experience in order to achieve success.For more discussion on this subject, see the information on how to determine obstruction in the epididymis.

My wife and I would like to give you and your staff a hearty "thank you" for the professionalism and care given us...following my son''s departure to our heavenly Father. Your calming manner and assurance that we had a reasonable chance at reattaching my vas deferens, which might allow us to get pregnant, was at fruition soon after our stay in Tacoma. 14 days following the procedure, my wife ... had become pregnant!. We lost our first son, and Dr. Finnerty, touched by God, enabled us to have another son ...
J.G., Washington
My husband had a vasectomy reversal four and one-half years ago performed by Dr. Finnerty. Three and one half years after, we were able to conceive a child. Our daughter is such a constant joy in our lives.
C.J., California
Our family now has 7 blessings, 3 of which you had a very special part in. Thank you!
G.S., Alaska
My husband had his vasectomy nearly 13 years before the reversal, which resulted in the birth of our daughter.
R.B., California
Easter blessings to you and your family from us. We are having a special celebration and invite you to join us -- we celebrate the life of our new daughter.
C.K., California
I am writing to send our heartfelt thanks to you for your expertise. On September 9th, you performed my husband''s procedure. Three weeks later, we conceived our first daughter. She was born exactly 43 weeks post-op. Since then, we have welcomed a son and also another daughter. We''ll always be grateful.
M.H., Vancouver, WA
Our child is a true gift from God. God bless you for turning my vasectomy around after 30 years with so much care and love. We will always love you.
J.C., Tennessee
A child is God''s most precious gift. We joyfully announce the birth of our son.
J.C., Idaho
Thank you again for making possible the blessings God had in store for us in the way of children ...
T.P., Minnesota
We were very excited to learn just before Christmas that the surgery was a success. We saved the news for out kids until Christmas Eve and what a blessing their reaction was, it couldn''t have been a better Christmas present! We do thank you so much for providing your services at realistic fees, we could never have done it had there not been options other than what we found locally.
T.S., California
We have been so excited about our new son and he has been such a joyous addition to our family ... Thank you so much for your devotion and belief in vasectomy reversal, we have been so blessed by our little guy. Of course, he can never take the place of our daughter who died, but he sure brings new joy to us ... Again, thank you for all you did! We have been so blessed....
M.M., Camas, WA
A little over 5 years ago, my husband and I flew from Chicago to your office to have his vasectomy reversed. We both want you to know how grateful we are -- to you, to your staff, and for your expertise. Since the surgery, we have had Michael (almost 4!) and Mary Jo (10 months) ... We feel it is important for you to know what a difference you made in our lives, and what an awesome grace it was to have you as our surgeon. Words cannot convey how much we appreciate what you have made possible for us -- we will be eternally grateful!
C. & K.P., Chicago
Thank you for helping our dreams come true.
J.W., Atlanta
We wanted to share our delightful news with you. We were blessed with a beautiful baby daughter in October.
D.W, Oregon
The reversal surgery was a great success! We are sorry we didn''t contact you sooner. Thank you again for your willingness to provide such a special service for families.
M.F., California