How to a Select a Vasectomy Reversal Doctor

IHR.com directory of vasectomy reversal doctors


Men choose to reverse their vasectomies for different reasons. Due to changes in life circumstances, what once seemed like a good plan, may no longer be.  A couple may decide to have more children. A man who, at one point didn't want any children, has changed his mind.  Or, the man may remarry and want to have a child with his new partner. Whatever the reason, it is a significant decision, and choosing a vasectomy reversal doctor should be done with knowledge and care.

It's not uncommon for a man to first turn to the doctor who performed the vasectomy. While this makes sense, the doctor may not have adequate experience in performing vasectomy reversal surgery.

When trying to select a vasectomy reversal doctor, here are some points to help with your evaluation:

Experience

While many surgeons offer vasectomy reversals, most don't regularly perform all of the types of vasectomy reversal surgeries performed by specialists. In addition to greater experience, specialists are often more knowledgeable about the emerging technologies involved in reversal surgeries.

When choosing your surgeon you need to look for two areas of proficiency. The surgeon must have:

  1. significant expertise in microsurgery (a very specialized field of surgery) as well as
  2. a sophisticated knowledge of the field of male infertility.

This will allow him/her not only to conduct the appropriate type of surgery most effectively, but also will allow him/her to analyze sperm, recommend treatment and work with the female's infertility specialist.

Microsurgery is a highly specialized field and microsurgical techniques and tools vary greatly from techniques used in general urologic surgery. The surgery is performed under an "operating microscope," a microscope that stands over the patient. The physician looks through the microscope at a highly magnified view during the entire procedure and this allows him/her to manipulate the incredibly small and fine instruments by hand. [In trying to visualize the minute size, imagine connecting a piece of spaghetti (the vas deferens) to wet tissue paper (the epididymis) with a piece of hair (the suture)].

It is also critical that urologists performing the surgery have significant ongoing experience with this particular procedure. They need to be capable of evaluating the sperm quality at various points and determine where the most effective reconnection can be made. As part of their specialized training, specialists in male infertility obtain an expertise in microsurgery from exposure to a large number of varied cases during an extended training.

Your physician should also specialize in male infertility. This will enable him to assess your semen analyses over time and work effectively with your partner's physician to determine when and how the sperm should be used in order to achieve a pregnancy. For example, if low levels of sperm are obtained, then this may be used with either an intra-uterine insemination or an IVF. If there are significant antibodies, intra-uterine inseminations may be considered. Ideally your surgeon should not only be comfortable with the surgery, but should also be comfortable with the field of male infertility and the interface between male and female infertility.

Be sure to ask each doctor about the number of procedures he/she performs in a week or month and, if possible, for referrals.

Surgical Methods

The reversal procedure can be conducted more than one way. Talk to your vasectomy reversal surgeon about which method he/she thinks is best for your case. If your vasectomy was more than 9 years ago, it's best if you see a specialist who frequently performs the more complicated vasoepididymostomy or "bypass" procedure.

Cost

While cost should not be the sole factor in choosing a vasectomy reversal doctor, most people must consider the high costs of specialized procedures, especially since vasectomy reversals are rarely covered by insurance. Talk to potential surgeons about how they arrive at their costs for the vasectomy reversal surgery.

 

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