Microscopic Vasectomy Reversals
The goal of the vasectomy reversal procedure is to surgically re-establish the normal flow of sperm. Factors that influence success rates include the type of connection needed (vas-to-vas vs. vas-to-epididymis) as well as the types of surgical techniques used. Another factor is the man’s individual genetics, as some men are prone to form more or less scar tissue in this area as they heal. Sperm counts and quality often take time to improve following a reversal as the system adjusts to its new, non-obstructed environment. Typically, sperm return to the ejaculate within the first 2 to 6 months following reversal surgery, but it can take longer or shorter amounts of time in individual circumstances.
By the latest WHO criteria, normal sperm counts are defined as 15 million sperm/cc with a motility (% of sperm swimming) of greater than or equal to 40%. Morphology (the % of sperm with perfectly normal shapes) is highly lab-dependent and its association with fertility outcomes is less clear. The goal is to get the highest number of the best quality sperm possible for optimal rates of pregnancy. As mentioned above, sperm are usually returning within the first 2 to 6 months, and the numbers and quality of sperm tend to improve over the first 6 to 12 months.