Vasectomy Reversal Procedure

Vasectomy-Reversal-Overview-Things To Know

By Inder Walia

Excellence in the medical field is represented now and again, when health is restored, lives are saved, new lives are brought forth and more. Some call it miracles, some call it magic and some just ascribe it to the advancement of medical science. Today Vasectomy reversal is possible! Nothing less than a miracle, it is a gift of science to mankind.

Vasectomy is the most effective long-term contraceptive method. It is conducted in the first place when an individual makes the decision of not wanting to father any more children in his remaining life span. However, different reasons such as remarriage, untimely demise of a child, desire to become a father etc, may trigger the need of vasectomy to be reversed. Twenty years ago the idea would have been unthinkable. However, today it is not only possible but millions of people find their lives enriched by the squeals of little babies, thanks to vasectomy reversal!

Before going in for a vasectomy reversal, it is advisable to be armed with a thorough understanding of the procedure, various surgical techniques, vasectomy risks, post vasectomy complications and recovery details. The procedure of conducting a vasectomy reversal is called a vasovasoctomy in medical terms. This is a kind of outpatient microsurgery conducted usually by a urologist, under the influence of local, spinal, epidural or general anaesthesia.

The first point to consider when deciding upon the micro-surgical reversal technique of vasovasostomy is the selection process of a vasectomy reversal doctor. Surgeons with extensive training in microsurgery and who perform many vasectomy reversals each year, obtain the best results.

Now to answer the main question- how is vasectomy reversal conducted? Vasovasostomy is essentially a two-step procedure. The first thing the surgeon needs to ascertain is the availability of sperm by examining a drop of fluid removed from the testicular end of vas deferens. Depending on the kind of sperm found, the appropriate type of microsurgical reconstruction needs to be performed.

The second step is to meticulously place sutures to sew the two ends of vas deferens. The channel within the vas deferens, which carries the sperm flow, is only 0.2 to 0.3 millimetres in diameter, which is roughly the size of a pinpoint. Thus, the procedure is to be carried out under a microscope that makes for better visualization, magnifying structures 20 times their actual size. This helps avoid imprecise suture placement. To ensure a leak proof connection, one-layer, two-layer or even three layer sutures may be drawn.

The majority of men who undergo vasectomy have epididymal blowouts, which are caused due to build up of pressure in the epididymis, the tube that carries sperm from the testicles to the vas deferens. The increased pressure results in a leak. The procedure used to suture epididymal blowouts is called Microsurgical Vasoepididymostomy.

Vasectomy reversal has been known to have successfully worked for patients up to 30 years following vasectomy with pregnancy occurring as early as a few months post reversal. If a vasectomy reversal is not successful due to scarring at the surgery site or imprecise suture placement or any other reason, it does not entail a complete loss of hope to reverse vasectomy. Redo vasectomy reversals have been conducted all over the world with considerable success.

Vasectomy reversal is a lifeline that has brought hope, joy, and laughter into several hearths and homes, and it shall continue to do so until science comes up with a new technology to replace this one. Till then, vasovasostomy is every vasectomized mans best bet to become fertile again.

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Vasectomy and Pregnancy

By Inder Walia

Post Vasectomy fertilization is a possibility! Renewed patency is bliss for some and an impediment for others. The risk is low but cases of pregnancy after vasectomy have been recorded. Several studies conducted to map the incidence of pregnancy after vasectomy vary by a few numbers. One study revealed only 3 cases of pregnancy out of 3,178 vasectomized men who were tested. The point to remember is that even if no sperm is found in a semen analysis post vasectomy reversal, it does not completely rule out the presence of motile sperm, which may later contribute to pregnancy.

The reasons behind pregnancy after vasectomy could be technical error, the reopening of the occluded passageway that carries sperm or the presence of residual motile sperm in the seminal vesicles even after vasectomy. The restoration of the sperm channel may happen early or late. An early recanalization (spontaneous reconnection of the vas deferens) may be detected in the post-vasectomy specimens. However, late recanalization is said to occur when several post vasectomy specimens do not show any sperm, which is discovered years after when the pregnancy has already occurred.

The above discussion relates to natural vasectomy reversal, which may not always come as a pleasant surprise! Thus, it is recommended to continue using contraceptives such as birth control pills for at least six months post vasectomy. This is because a minimum of twenty ejaculations after vasectomy have been found to contain viable sperm. On the other hand, there are couples, which after vasectomy may be desirous of more children and that chance pregnancy may not happen to them. Thats where the Vasectomy reversal procedure by a specialist comes into the picture!

Vasectomy reversal pregnancy rates are defined by factors such as the success rate of complicated epididymal surgeries that have to be conducted on most reversals. Besides, the sperm count, quality and fertility has also been noticed to decline progressively with the years after vasectomy. However, reversals performed even 20 or more years after vasectomy have known to succeed after epidiymal surgeries. Besides, new techniques of microsurgical epididymal surgery are contributing to an increase in the success rate of pregnancy after vasectomy reversal.
There are several success stories of pregnancies after vasectomy that have brightened the lives of several people. Success rate varies with the methodology used, the experience and expertise of the vasectomy doctor and the years between vasectomy and the reversal attempt. It takes an average of 12 months, and at the most 2-3 years between vasectomy reversal and the pregnancy to occur. Thus, if you decide to have another child years after vasectomy, youve got hope. So do millions of people across the globe who want to grow their families. Vasectomy reversal helps you achieve the delight, happiness and pleasure of parenthood!

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Vasectomy Reversal

Who asks for vasectomy reversal and why?

G Howard

Of the 76 men requesting reversal of vasectomy who were interviewed at Charing Cross Hospital between June 1978 and September 1981, 31 were still married. These men had decided to have a vasectomy during a crisis-a recent pregnancy or financial stress being the commonest reason. Most wanted another child but others wished to be “put back to normal,” and a few hoped reversal would help their marriage. Forty-five (59%) were divorced or separated and felt disadvantaged in courtship or remarriage by being infertile, many wives or partners being “desperate” for a pregnancy. A greater number of requests for reversal came from men who had been under 35 at the time of vasectomy and who were more likely to have been divorced, especially if there had been a teenage pregnancy. The risks of regret after sterilisation appear to relate to immaturity at the time of the vasectomy and to be as great for young men as for young women.

Source: Br Med J (Clin Res Ed). 1982 August 14; 285(6340): 490492.

What to Expect after Vasectomy Reversal Surgery

By Inder Walia

An effective vasectomy reversal is a result of expertise and experience! The microsurgical technique of multi-layer 10-0 suturing achieves the highest success.
The surgery involves surgical removal of fluid from the testicular end of vas deferens to check for colour, consistency, volume and presence of motile sperm. Once the health of the fluid is established, the two severed ends of vas deferens are reconnected to allow for unobstructed flow of sperm into the fluid that is eventually ejaculated at orgasm.

The operation, as described above, is conducted under a general anaesthetic and takes an average of two hours to complete. In another couple of hours the anaesthesia wears off and one may return home the very same day! Oral medication, as prescribed by the doctor, is good to relieve mild discomfort. It is advisable to rest and lie down as much as you can for the next few days. Within three weeks youll be up and about, performing normal activities and resuming a healthy sexual life. However, do avoid strenuous activity and wear a jockstrap for support.

Complications after vasectomy reversal are uncommon, but you

may expect bleeding from the incision made on the scrotum,

a scar that heals with time and

a rare infection that may be recognized by heightened pain and discomfort. In the case of any of the above post vasectomy complications, please contact your vasectomy reversal expert immediately!

You will be required to visit your vasectomy reversal doctor within five days after surgery for a follow up. Subsequently, visits for semen analysis would be requested every two or three months. The semen may at the beginning show very low sperm count with impaired motility. However, with time, the sperm count and motility improves, until it becomes absolutely normal in eight months time.

Fibrosis, which is a condition characterized by gradual scarring at the reversal site, causes loss of all sperm in the ejaculate in approximately 6% of the men who get a vasectomy reversal. Thus, storing sperm after vasectomy reversal is a good idea!

Very few pregnancies occur within the first few months of a vasectomy reversal. The average time is twelve months, while it may take several years to show any success. If the pregnancy does not occur within three years after vasectomy reversal, medical investigations would be recommended.
Moreover, the instances of pregnancy after vasectomy reversal are not 100%. Even a normal semen analysis may not be a definite indication of achieving a pregnancy. This would be due to the development of antibodies against sperm, which is as common as 75% of all vasectomies performed. That of course, interferes with the process of fertilization.

Thus, the procedure of a vasectomy reversal is uncomplicated. Consult your urologist about all the other options available. It is definitely worth giving your family the chance of a baby!

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Vasectomy and its Microsurgical Reversal

In our series the overall pregnancy rate after vasovasostomy in an unselected group of early patients was 71%. Recovery of fertility correlated with the return of normal sperm counts and with the quality of vas fluid on the testicular side of obstruction at the time of vasovasostomy. The three most important factors in our group influencing return of fertility after vasovasostomy were a meticulous microscopic technique for reconnection, the duration of time the vas deferens has been obstructed, and the presence or absence of a sperm granuloma at the site of vasectomy. The presence of a sperm granuloma at the site of vasectomy virtually ensured the presence of good quality sperm in the vas fluid at the time of vasovasostomy. If all three of these factors are favorable, vasectomy may be reversible for more patients.
Source: Silber SJ.: The Urololic Clinics of North America. 1978 Oct;5(3):573-84.

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Vasectomy Reversal

What to Expect after Vasectomy Reversal Surgery

By Inder Walia

An effective vasectomy reversal is a result of expertise and experience! The microsurgical technique of multi-layer 10-0 suturing achieves the highest success.
The surgery involves surgical removal of fluid from the testicular end of vas deferens to check for colour, consistency, volume and presence of motile sperm. Once the health of the fluid is established, the two severed ends of vas deferens are reconnected to allow for unobstructed flow of sperm into the fluid that is eventually ejaculated at orgasm.

The operation, as described above, is conducted under a general anaesthetic and takes an average of two hours to complete. In another couple of hours the anaesthesia wears off and one may return home the very same day! Oral medication, as prescribed by the doctor, is good to relieve mild discomfort. It is advisable to rest and lie down as much as you can for the next few days. Within three weeks youll be up and about, performing normal activities and resuming a healthy sexual life. However, do avoid strenuous activity and wear a jockstrap for support.

Complications after vasectomy reversal are uncommon, but you

may expect bleeding from the incision made on the scrotum,

a scar that heals with time and

a rare infection that may be recognized by heightened pain and discomfort. In the case of any of the above post vasectomy complications, please contact your vasectomy reversal expert immediately!

You will be required to visit your vasectomy reversal doctor within five days after surgery for a follow up. Subsequently, visits for semen analysis would be requested every two or three months. The semen may at the beginning show very low sperm count with impaired motility. However, with time, the sperm count and motility improves, until it becomes absolutely normal in eight months time.

Fibrosis, which is a condition characterized by gradual scarring at the reversal site, causes loss of all sperm in the ejaculate in approximately 6% of the men who get a vasectomy reversal. Thus, storing sperm after vasectomy reversal is a good idea!

Very few pregnancies occur within the first few months of a vasectomy reversal. The average time is twelve months, while it may take several years to show any success. If the pregnancy does not occur within three years after vasectomy reversal, medical investigations would be recommended.
Moreover, the instances of pregnancy after vasectomy reversal are not 100%. Even a normal semen analysis may not be a definite indication of achieving a pregnancy. This would be due to the development of antibodies against sperm, which is as common as 75% of all vasectomies performed. That of course, interferes with the process of fertilization.

Thus, the procedure of a vasectomy reversal is uncomplicated. Consult your urologist about all the other options available. It is definitely worth giving your family the chance of a baby!

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Vasectomy Reversal

Basics of Vasectomy Reversal

After vasectomy, sperm are still made by the testes, but since the vas tubes have been blocked, they cannot exit in the usual way. On each side, sperm can still enter the epididymis (the very long coiled tube behind the testis where sperm normally become mature) and the lowermost portion of the vas tube upstream from the obstruction imposed by the vasectomy. After vasectomy, the very fine tubes of the epididymis can become blocked. There are two possible explanations for this.

In the epididymis, white blood cells in the normal testicular circulation ingest and recycle the trapped sperm. This increased white blood cell activity is a chronic inflammation by definition. Inflammations can lead to scarring, and scarring in a very fine tube like the epididymis can cause obstruction. For example, inflammation of the liver (hepatitis) can cause scarring of the liver (cirrhosis); inflammation of joints (arthritis) can cause scarring with stiffness and decreased range of motion. The longer the duration of the inflammation, the greater the likelihood of scarring and obstruction, and this can occur in the epididymis, just as it can in any organ.

An alternative explanation for obstruction in the epididymis after vasectomy is that pressure increases upstream from the vasectomy site and can cause a “blowout” in the fine tubes of the epididymis, resulting in leakage of sperm and local inflammation and blockage.

Whatever the explanation for the obstruction in the epididymis (scarring or blowout), its likelihood is roughly proportional to the number of years that have gone by since the vasectomy. After an interval of only 1-3 years, the epididymis is rarely blocked, but after an interval of 20 years, the likelihood of secondary obstruction may be over 30%. Fixing the vas where it was divided at the time of the vasectomy (vasovasostomy or “VV”) will not correct the secondary obstruction upstream in the epididymis. That requires a more elaborate procedure called a vasoepididymostomy or “VE”, in which the portion of the vas tube above or “downstream” from the vasectomy site blockage is connected to the portion of the epididymis “upstream” from the secondary obstruction.

Microscopic Vasectomy Reversal

More than 300 patients undergoing microscopic vasovasostomy have been carefully studied in an effort to determine the factors which affect the recovery of fertility after an accurate microscopic reanastomosis. The over-all pregnancy rate in an unselected group of early patients was 71%. Recovery of fertility correlated with the return of normal sperm counts and with the quality of seminal fluid in the vas deferens on the testicular side of the obstruction at the time of vasovasostomy. The three most important factors influencing return of fertility after vasovasostomy are (1) a meticulous microscopic technique for reconnection, (2) the duration of time the vas deferens has been obstructed, and (3) the presence of absence of a sperm granuloma at the site of the vasectomy, venting the long-term pressure buildup which otherwise would occur. The presence of a sperm granuloma at the vasectomy site generally ensured the presence of good quality sperm in the vas fluid at the time of vasovasostomy and the recovery of a good sperm count postoperatively. If all three of these factors are favorable, vasectomy should be reversible for most patients.
Source: Silber SJ.: Fertility and Sterility. 1977 Nov;28(11):1191-202.

Vasectomy Reversal — Men Can Also Change Their Minds!

By Antony Wilton

Prior to undertaking a vasectomy reversal, it is important to discuss with your doctor all aspects of the operation and your personal situation, to pinpoint significant issues that will impact upon the ultimate result.

The extent of the period from vasectomy to reversal is an important factor, as success rates are known to diminish the longer the break has been. This is due to the increased probability of pressure injury sustained in the epididymis or even a blockage within it.

Your doctor will be interested in any history of complications that may have occurred after the the vasectomy such as scrotal hematoma or any post operative epididymis infection. Your partners reproductive potential will also be assessed and you must realise that if you were was having difficulty with conception before your vasectomy, this situation is unlikely to change after vasectomy reversal. Also, your specialist will try to procure your surgical notes relevant to your vasectomy to determine, if possible, how your vasectomy was actually carried out.

For instance, depending whether the vasectomy was performed high up on the tube or quite low down near the epididymis, could have an effect on the difficulty of the reversal surgery. Your physician will also analyse your physical make up to get a superior understanding of what he will encounter during the reconstruction.

Small spongy testes can suggest impaired sperm manufacture and project a poor result.
An enlarged or uneven epididymis can mean secondary epididymal impediment that may require a vasoepididymostomy. On the other hand, an incidence of a sperm granuloma is a satisfactory diagnosis as these sperm granulomas allow for the venting of high pressure away from the epididymis, and subsequently allowing protection from pressure induced harm.

If you have a sperm granuloma your prognosis is good irrespective of the period since the vasectomy took place.

When a very harmful vasectomy has been undertaken, it is conceivable that large portions of the vas have been excised or cut out. This may mean that extensions of the incisions may be required to establish a tension free reconnection leading to more complicated surgery. Naturally, if a satisfactory outcome is obtained by re establishing sperm flow in the man, a successful pregnancy can only be obtained providing the female is also capable of giving birth.

The woman should organize for a gynecological examination to guarantee that she is able to conceive. How near she is to menopause can be also be an issue because of the time that it may take for sperm flow to be re established in the man following a successful vasectomy reversal.

These are just some of the considerations that need to be taken into account before undertaking a vasectomy reversal.

Author Antony Wilton discusses important mens issues on his site
Vasectomy Reversal
His regularly updated blog can be found at
Vasectomy Reversal Blog

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Vasectomy Reversal

The Boys in Pink: The Batangas Mountain Bikers

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Vasectomy-Reversal-Overview-Things To Know

By Inder Walia

Excellence in the medical field is represented now and again, when health is restored, lives are saved, new lives are brought forth and more. Some call it miracles, some call it magic and some just ascribe it to the advancement of medical science. Today Vasectomy reversal is possible! Nothing less than a miracle, it is a gift of science to mankind.

Vasectomy is the most effective long-term contraceptive method. It is conducted in the first place when an individual makes the decision of not wanting to father any more children in his remaining life span. However, different reasons such as remarriage, untimely demise of a child, desire to become a father etc, may trigger the need of vasectomy to be reversed. Twenty years ago the idea would have been unthinkable. However, today it is not only possible but millions of people find their lives enriched by the squeals of little babies, thanks to vasectomy reversal!

Before going in for a vasectomy reversal, it is advisable to be armed with a thorough understanding of the procedure, various surgical techniques, vasectomy risks, post vasectomy complications and recovery details. The procedure of conducting a vasectomy reversal is called a vasovasoctomy in medical terms. This is a kind of outpatient microsurgery conducted usually by a urologist, under the influence of local, spinal, epidural or general anaesthesia.

The first point to consider when deciding upon the micro-surgical reversal technique of vasovasostomy is the selection process of a vasectomy reversal doctor. Surgeons with extensive training in microsurgery and who perform many vasectomy reversals each year, obtain the best results.

Now to answer the main question- how is vasectomy reversal conducted? Vasovasostomy is essentially a two-step procedure. The first thing the surgeon needs to ascertain is the availability of sperm by examining a drop of fluid removed from the testicular end of vas deferens. Depending on the kind of sperm found, the appropriate type of microsurgical reconstruction needs to be performed.

The second step is to meticulously place sutures to sew the two ends of vas deferens. The channel within the vas deferens, which carries the sperm flow, is only 0.2 to 0.3 millimetres in diameter, which is roughly the size of a pinpoint. Thus, the procedure is to be carried out under a microscope that makes for better visualization, magnifying structures 20 times their actual size. This helps avoid imprecise suture placement. To ensure a leak proof connection, one-layer, two-layer or even three layer sutures may be drawn.

The majority of men who undergo vasectomy have epididymal blowouts, which are caused due to build up of pressure in the epididymis, the tube that carries sperm from the testicles to the vas deferens. The increased pressure results in a leak. The procedure used to suture epididymal blowouts is called Microsurgical Vasoepididymostomy.

Vasectomy reversal has been known to have successfully worked for patients up to 30 years following vasectomy with pregnancy occurring as early as a few months post reversal. If a vasectomy reversal is not successful due to scarring at the surgery site or imprecise suture placement or any other reason, it does not entail a complete loss of hope to reverse vasectomy. Redo vasectomy reversals have been conducted all over the world with considerable success.

Vasectomy reversal is a lifeline that has brought hope, joy, and laughter into several hearths and homes, and it shall continue to do so until science comes up with a new technology to replace this one. Till then, vasovasostomy is every vasectomized mans best bet to become fertile again.

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How Much Down Time to Expect

Patients must use greater caution following vasectomy reversal than following vasectomy, even more so following VE vs. VV . Depending on the surgeon’s protocol, patients may return to work 4-21 days following the procedure.

Vasectomy Reversal - Things You Should Know

By Inder Walia

Vasectomy reversal is conducted with an aim to restore fertility in the life of couples that want to explore the joys of parenthood. Vasectomy is considered the most reliable and safe contraceptive method that prevents more pregnancies every year than any other method of birth control. However, with changing times, attitudes, priorities, and financial and emotional circumstances also undergo transformation. One may later in life, feel the need to get a vasectomy reversal. A reversal scores higher than all other available options because its more natural, less expensive and potentially more effective!

It is critical to garner all information regarding vasectomy reversal before deciding to take the plunge! The following are a few pointers to quickly walk you through all that you need to know about vasectomy reversal.

What exactly is vasectomy reversal? Reverting of Vasectomy is a microsurgical procedure that can backtrack vasectomy. It involves the single or multiple suturing of the two severed ends of vas deferens, the tubes that carry sperm from the epididymis to the prostate. This allows for the renewed flow of sperm through the vas deferens in the male reproductive tract. This sperm goes on to become part of the semen ejaculated at orgasm and thus brings about the ability to father children. This medical procedure is known as a “vasovasostomy. If there is a blockage due to the increased pressure in the epididymis, it must be bypassed in an alternate form of surgical procedure known as a “vasoepididymostomy.

The cost of Vasectomy Reversal- It is a good idea to investigate the total expenditure of a vasectomy reversal, which may be anywhere from $4,000 to $20,000. Unlike vasectomy, most insurance companies do not cover the reversal procedure. The asking price may vary among physicians, states, and according to the methodology used. For instance, the services of a vasectomy reversal expert in the US may cost you an average of $10,000. The same would cost you $5000 in Canada. This is all inclusive of the three fees applicable for a vasectomy reversal, which are the surgical fee, the anaesthetic fee and the hospital fee. It is however possible to lessen the charges by opting for an operation at an outpatient surgical centre instead of a hospital. That may reduce the price of a vasectomy reversal to anywhere from $2500 to $4000. Furthermore, in case of a vasoepidiymostomy, the overall cost of the reversal will mount, as this procedure is more complex and time-consuming.

How successful is Vasectomy Reversal? Vasectomy reversal is quite successful! The success rates again vary in accordance with factors such as the duration after vasectomy, experience, expertise and the course of action or approach of your surgeon towards vasectomy reversal. A recent study focussed on vasectomy reversal and conducted on over 1000 couples revealed that if the duration after vasectomy was less than three years, 75 percent of couples achieved a pregnancy, if three to eight years, 50 percent, nine to 14 years, 40 percent and over 14 years post vasectomy, 30 percent of couples achieved a pregnancy. The overall pregnancy rate was 52 percent. Repeat vasectomy reversals were less winning with only 40 percent of pairs accomplishing a pregnancy. In addition, success rates vary from surgeon to surgeon, some boasting of as much as a 97% success rate of a straightforward vasectomy reversal.

Complications- Though rare, there may arise some difficulties following vasectomy reversal. These include the oozing of blood from the corners of the scrotal incision, which usually stops within 12 hours following the procedure. Some patients may incur a large bruise that settles with time and rest. Also, there are chances of an infection that is quite painful, accompanied by the scrotum acquiring a red colour. Immediately contact your vasectomy reversal doctor in case of any of the above complications!

Choosing your Vasectomy reversal expert- The reversal surgery is specialized and technical and demands extensive training in microsurgery and an experience of conducting several reversals throughout a year. Skill, experience and expertise are major factors that have a bearing on the success of vasectomy reversal. Other than that, ensure that your surgeon not only has had formal fellowship training but also is licensed to practise in your state or province. Confirm that your micro surgeon /reversal specialist performs the reversal using an operating microscope, and 2-layer closure with 10-0 nylon sutures. It would also be wise to check out the surgeons statistics for number of reversals per year, number of successes, complication rates and whether or not he has a university appointment.

Pregnancy after vasectomy Reversal- The statistics for pregnancy post vasectomy, as mentioned above, are quite encouraging! After vasectomy reversal a couple may attain pregnancy within a couple of months. The standard duration is at least a period of 12 months. Most pregnancies occur with in a period of two years after the reversal.

Armed with the above knowledge, it is now time to make your decision. It is best not to delay vasectomy reversal because even if you do not plan a child for the next one or two years, it must be borne in mind that post vasectomy reversal pregnancy takes an average time of twelve months. In addition, the more you delay, the more affected are your chances of attaining patency. Hope this information helps you make an informed decision about your and your familys future!

Inder Walia

For all the Vasectomy related questions, please visit www.vasectomyreversalnews.com.

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What is the Success Rate…

Nationwide vasectomy reversal success statistics are readily available. The most commonly cited article is the report of the Vasovasostomy Study Group which appeared in the Journal of Urology in March, 1991 (J Urol 145:505-511, March,1991; you can review or copy the article at your local hospital medical library). The single most important parameter determining success is the number of years since vasectomy. Within the first 3 years after vasectomy, reversal results in sperm recovery in over 97% of cases. From 3 to 8 years, about 91%; from 9 to 14 years, about 82%; and beyond 14 years, about 69%. Pregnancy rates (without fertility assistance) also drop slowly with time (from about 80% in the 3-year group to 35% in the >15-years group).

Vasectomy Reversal

The Juniors

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