The Hudson Valley's
Premiere Urology Specialists

T 914-347-1900
F 914-347-1957

Infertility

and Vasectomy Reversal: Everything you need to know

couple with baby The male fertility process involves the production of mature sperm and getting the sperm to reach and fertilize the egg. Although it may seem to be a simpler process than female fertility, male fertility also requires many conditions to be met: the ability to have and sustain an erection, having enough sperm, having enough semen to carry the sperm to the egg, and having sperm of the right shape that move in the right way. A problem meeting any of these conditions contributes to infertility.
Like female infertility, male infertility can result from physical problems, such as testes that don't make enough normal sperm, hormonal problems, and lifestyle or environmental factors, including (but not limited to):
  • Age
  • Stress
  • Varicocele, an enlargement of veins draining the testes
  • Cryptorchism, or a testis that has not fully descended into the scrotum at birth
  • Tight fitting underwear
  • Smoking, drugs, and alcohol
  • Medications
  • Environmental toxins
  • Genetic conditions, such as Klinefelter syndrome
  • Other health problems such as cystic fibrosis
Although not getting pregnant is an indication of possible infertility, only a health care provider can provide a diagnosis of infertility. Those who suspect they are infertile should see their health care providers, including:
  • Couples who have been trying to conceive for a year without getting pregnant
  • Women who have experienced menstrual irregularities or who have had endometriosis or uterine fibroids
  • Women who have gotten pregnant but who have had more than one miscarriage or stillbirth
  • Men and women with certain genetic conditions
couple consulting There are a variety of ways to treat infertility, including:
  • Medication
  • Surgery
  • Intrauterine insemination/artificial insemination (woman is injected with carefully prepared sperm from the husband, partner, or a donor)
Assisted reproductive technology (ART), such as in vitro fertilization Most often, health care providers treat infertility with medication or surgical repair of the reproductive organs. In addition, lifestyle changes may also help alleviate infertility, such as reducing stress, diet modification, stopping use of drugs or alcohol, or reducing the temperature around the testes.
The purpose of a vasectomy is to become sterile, a surgical form of birth control. Some men decide later that they wish to become fertile again in hopes of fathering children. In some cases, a reversal of the vasectomy is possible through microsurgery. Male Fertility
In general, a healthy, sexually active male, who was fertile before a vasectomy, can be considered for reversal. However, a very thorough discussion of the risks and benefits must be made with your doctor, a detailed history and physical exam, and review of medical records. Older <am
The vasa deferens are small and the channel the sperm swim through are very tiny, about 1/2 to 1 mm across. Microsurgery is required. Therefore, a patient must go under general anesthesia. Small incisions in the scrotum are made to find the area where the vasectomy was performed. Two fresh ends of the vas deferens are then sutured together with sutures about the size of the human hair. The incisions in the scrotum are then closed with dissolvable suture. As with any surgical procedure, a careful discussion of post-op care and recovery is necessary.
An example of how there will besSmall incisions in the scrotum are made to find the area where the vasectomy was performed

An example of how there will besSmall incisions in the scrotum are made to find the area where the vasectomy was performed

There has been much research in predicting which men have a successful vasectomy reversal. In general, success goes down > 10 years since the vasectomy. During microsurgery, there are signs, like active sperm production, that predict success. In general, vasectomy reversal can result in sperm in the ejaculate in about 65% of selected cases.
Microscope Imaging of sutures in vas reconstruction.  The knot shown is about as large as the period at the end of this sentence.

Microscope Imaging of sutures in vas reconstruction. The knot shown is about as large as the period at the end of this sentence.

vaso