There are many variables which may affect the success of vasectomy reversal surgery. Obviously, the experience and skill of the reversal surgeon is a crucial factor. The technique of vasectomy, the complexity of the repair, the time since vasectomy, your age, how well you heal, prior reversal surgery, and many other factors can also influence surgical success rates. Many of these factors are outside the control of the surgeon, no matter how skilled.
Unfortunately, reversal surgery—even expertly performed using microsurgery—can sometimes fail to successfully reconstruct the duct system, resulting in no sperm or very low sperm counts postoperatively.
Some reversal surgeons offer to repeat your surgery if there has been no pregnancy within a period of several years. While this may be well-intentioned, it is misleading. Even if a surgeon has 100% technical success rates (which no surgeon has), many of those patients will be unable to achieve pregnancy because of sperm quality problems having nothing to do with the surgery. Offering additional surgery to those for whom surgery is not the answer—even if performed for free—is offering a false hope.
Others guarantee their surgery, but use the technicality of seeing any sperm on a postoperative count to define “success”. But very low sperm counts are often (although not always) an indicator of scarring and obstruction at the reconnection site, especially when they stay very low for over 6 months after surgery.
Dr. Finnerty believes the best way to approach absent or very low sperm counts after surgery is by an honest discussion of the likelihood that these sperm counts are due to surgical obstruction (and can therefore be corrected by additional surgery), and a recommendation for the best course to follow to achieve pregnancy. If you desire to repeat the surgery based on this discussion, there will be no surgical fee for the repeat surgery. This way you can be assured that every effort has been made to give you the best surgical outcome possible.
Hospital and anesthesia charges are unfortunately not under our control, and therefore will still apply if repeat surgery is performed.