The success of vasectomy reversal is defined by the presence of sperms in the semen after the reversal surgery. Pregnancy rates are generally lesser due to other male and female factors.
Vasectomy Related Factors
Time interval since vasectomy:
Reversals performed soon after vasectomies are more likely to be successful. With increase age of vasectomy, reversal success rates diminish.
Length of vas on testicular side of vasectomy
Longer the vas on testicular side of vasectomy, higher the chance of finding sperm during surgery. This is attributed to spread of the pressure to a larger surface area with lesser chance of blowout
Sperm granuloma at vasectomy site is a good sign. It is associated with higher chance sperm in vassal fluid.
Surgeon Related Factors
Experience and skill of surgeon:
Microsurgical skills require stability and dexterity of hands. Experience of surgeon is a key factor
Magnification: It I important to realize that not only a microscope is used but also the microscope is of good quality. The optics, illumination, power, controls and many other bells and whistle that come with newer high end microscopes make the visibility of lumen easier and thereby increasing the chance of success.
Most importantly, the quality of the fluid seen coming from the vas at the time of the operations determines whether the sperm would be present in semen after surgery.
If the sperm/s are present during surgery Dr. Agha’s success rate exceeds 95%.