Why should I choose Vasectomy Reversal Center of Chicago for my reversal?
Dr Agha is a Board certified Urologist with primary focus on the male infertility. He has been performing vasectomy reversals for over 16 years on regular basis (average 2 cases per week). He uses a very high end computerized operating microscope which facilitates this extremely delicate operation. Of course, only the right tools for the right job in skilled hands deliver the best results. The procedure is performed in a state of the art, fully accredited and Joint Commission approved Ambulatory Surgery Center.
What is your success rate?
If the sperm are found during surgery, our success (defined by the presence of sperm in the semen after reversal) is above 99%.
My vasectomy was done many years ago. Can it be reversed?
Vasectomy reversal can be performed even after many years of the blockage. However, longer the time interval from the vasectomy, lower the success rates. The chances that sperm will be discovered during surgery vary with time since vasectomy (95 % 1-3 years, 80-85% 4-7 years and 70-75% 8-14 years).
What are different types of vasectomy reversal?
The most common, called vasovasostomy, involves stitching the disconnected ends of the vas deferens back together with ultra-fine sutures. The other reversal procedure, called vaso-epididymostomy, is performed when inflammation or scarring from the original vasectomy blocks the epididymis – the tubular structure connecting the testes to the vas deferens. In this microsurgical procedure, the blockage is bypassed by surgically connecting the vas deferens directly to the epididymis in a new location.
What are the indications for Vasoepididymostomy?
When there is thick fluid or no fluid coming out of the testicular end of vas deferens, it suggests an obstruction in the epididymis. In such cases the connection of the vas is established to epididymis above the level of obstruction.
Should I have Sperm aspiration instead of vasectomy reversal?
Sperm acquired through aspiration or other retrieval techniques can only be used with in vitro fertilization for pregnancy. Under certain circumstances it may be a viable option e.g., too long a period (>15 years) since vasectomy and female partner’s age closer to menopause (40s plus when time seems to be running out). However the cost of pregnancy with in vitro fertilization is significantly higher. Many couples opt to have an initial attempt at reversal despite the longer number of years since vasectomy and keep sperm retrieval/IVF as a backup plan if reversal does not work.
What type of suture do you use?
9-0 Ethilon suture for vas to vas connection and 10-0 Ethilon for vasoepididymostomies.
Will I need General Anesthesia for the procedure?
No. In 99% of the cases Dr. Agha can perform the surgery under local anesthesia. Only rarely general anesthesia (GA) is needed in some special cases or per request. The advantages of local anesthesia include avoiding unnecessary additional cost and potential side effects of GA.
How will I feel after surgery?
There will be some swelling and bruising after surgery for 4-5 days. In addition there may be some mild bleeding or oozing from the stitches. You may like to rest and take easy for first 48 hours. Later on you may increase activity as tolerated. Sexual activity should be avoided for 3 weeks or longer if it is still uncomfortable. General guiding principle on activity is “if it hurts, don’t do it”.
When will I get my sperm checked?
Semen testing is generally performed at 2-3 months after reversal.
When can I expect pregnancy to happen?
It is variable. Even when reversal is successful, there are many factors that affect the outcome of pregnancy. In our experience the pregnancy has happened within 6-8 weeks on one hand and more than a year on others. Timing of sexual activity to ovulation improves the chances of success.
What is the cost for reversal?
The total cost of the vasectomy reversal at our center is $6600 It covers surgeon’s fee, facility fee and intra-operative medicine for local anesthesia and sedation. There is no additional cost for vasoepididymostomy or redo reversal. General anesthesia, if requested (<1% cases) costs an additional $1500.00. The cost is subject to change.
How can I pay for the procedure?
We do not accept insurance for this procedure. A $500.00 deposit is required to schedule a date of surgery. The balance of the fee is payable 2 weeks before surgery in the form of a cashier’s check, money order or cash. Credit card payemts incur a 3% convenience fee.
How do I make an appointment?
You can make an appointment by email, online or phone. Please see our contact page
Do I need tests for anti-sperm antibodies before my vasectomy reversal?
No specific or unique preoperative laboratory evaluation is needed before vasectomy reversal. Approximately 60% of men develop circulating antibodies against their sperm after the vasectomy. Controversy exists that such antibodies may decrease the chance of successful pregnancy after the vasectomy reversal. However, the overall postoperative conception rate is relatively high in the range of 50% to 70% and presence or absence of anti-sperm anti-buddies does not correlate with post-operative conception. Consequently, the value of preoperative antisperm antibody testing remains unproven. If such antibodies do in fact play a causative role in failure to conceive after a successful reversal, there are additional treatments and assisted reproductive techniques to address this situation.
Can the Sperm be frozen during vasectomy reversal?
Most of the times, after long-standing blockage from vasectomy, the sperm that are found at the time of reversal are noted to be dead, deformed and non-moving. At other times, however, moving sperm are found. If you desire to have these sperm frozen, a third-party lab is available for this purpose. Sperm freezing arrangements are done directly by the patient with the lab per Illinois laws and lab protocols. There is an additional cost for sperm freezing. An embryologist from cryopreservation lab will charge a standby fee even if the usable sperm are not found and sperm banking is not done. We do not recommend such expense because if the sperm are found during surgery, there is more than 95% chance that they will come out after surgery.