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Reversal Guarantees

We do not offer guarantees. There are inherent weaknesses in guarantees offered for reversal surgery (or any type of surgery), including:

1. How is success defined? Return of sperm to the semen? Up to 10% of patients (about 5% in my practice) who have had a successful reversal (post-operative semen reveals sperm) will develop recurrent obstruction six to twelve months after surgery due to delayed scarring at the reversal site. Would this be covered by the guarantee? Suppose the couple was using contraception during the first six months after the reversal because they weren't quite ready to be pregnant during their wedding, honeymoon, or house building. Could the surgeon renege on the guarantee because they might have gotten pregnant had they not used contraception temporarily after the reversal?

2. Suppose there is a return of sperm to the semen, but at numbers too low to result in pregnancy? Or suppose the semen after reversal contains many millions of sperm per milliliter, but 95% of them are inactive as a result of injury to the epididymis by congestion and/or inflammation during the years between the vasectomy and reversal.

3. If the guarantee is one for a repeat procedure in the event that pregnancy fails to occur after a specified time, how will the guarantee be fulfilled in the event that the surgeon has moved, taken a sabbatical, become ill or injured, or changed the focus of his practice during that interval? One of my patients, who failed to experience a return of sperm to the semen, went to a doctor who offered a "guarantee" of success. I called him four months after his "guaranteed" second reversal. He had been black and blue from his thighs to his waist and his scrotum had been swollen to the size of an orange for weeks after the second procedure, his semen was still devoid of sperm, and when I asked about the guarantee, he told me that he would NEVER go back to that doctor, who could "take his guarantee and shove it."

4. In addition, we have had a number of reversal couples who have become separated, fallen into financial difficulties, experienced serious illness, or simply changed their minds about starting over during the time of waiting for pregnancy to occur. In another office, they may have paid more for a guarantee that was never invoked.

We offer reversal services at a fee that is less than many offices. "Money-back guarantees" are good business for reversal surgeons. Since sperm recovery rates are about 85% for most practices (considering all intervals between vasectomy and reversal), let's consider the math. Even if sperm recovery were only 80% (to make the math simple), if I charge $3500 for 5 non-guaranteed reversals, my practice takes in $17,500 for those 5 reversals. If I charge $5000 for 5 guaranteed reversals, my practice takes in $25,000. For one "failure", I return $5000, and I'm still left with $20,000, $2500 more than I take in for non-guaranteed reversals. Guarantees simply transfer costs to those patients who experience sperm recovery. If the interval between vasectomy and reversal has been rather short, less than 7 years for example, sperm return to the semen with reversal in my practice is 95% (see Success Rates). If your interval is short, paying more for a "guarantee" would amount to much paid for little likelihood of benefit (return of funds in the event of failure). If you pay less for a non-guaranteed reversal and you enjoy success, you'll be happy to have the extra funds for maternity and baby expenses. If your interval is long, 15 years or more, sperm return to the semen with reversal in my practice is 70%, in which case paying extra for a guarantee may be a good investment, and in which case I wouldn't blame you for seeking the services of a reversalist who offers a money-back guarantee, as long as that guarantee is not adjusted for the longer interval.

"Pregnancy guarantees" are fraught with potential problems but offered by some reversal surgeons because they attract patients willing to pay higher fees to get the guarantee. They sound great, but what if you have many sluggish sperm in your semen and your partner still isn't pregnant after the specified interval? What good is a repeat reversal? And who can predict whether you and your partner will be together and healthy or that the reversalist will still be in practice after the specified interval?

The best "guarantee" is the knowledge that the honest reversalist, like any reputable surgeon, is as anxious to achieve a good outcome as is the patient. Please be aware that there is no governing authority over internet advertising and recently there has been litigation involving a Tampa urologist who was found liable in Federal Court (Case No. 8:02-cv-590-T-TBM) for false advertising with regard to his experience and success rates. A person who offers false claims in a website may be just as likely to make false claims by return e-mail or during personal communications. I would be happy to discuss this case and any aspect of vasectomy reversal if you would like to call me at home (813-949-5962) any evening up until 10:30, or anytime on my cell phone (813-390-3032). Or, feel free to call the office toll-free anytime (866-827-8463) for a consultation visit.