The single most important factor in whether a
vasectomy reversal attempt will be successful is the interval in time (years)
between vasectomy and vasectomy reversal. We keep all of our data on an Access
database which we can use to answer certain "queries", and which can
be exported to an Excel file and used to prepare the graphs you see below.
Updated data is published to this web page every 1-2 months. This allows any
reversal candidate the opportunity to determine the likelihood of sperm recovery
and pregnancy with a reversal in this office. Data published by other
offices or institutions is of little use to the couple trying to assess a
particular office. Vasectomy reversal is a gamble, and success rates and
fees vary from office to office, so all the evaluating couple can do is
determine where they may obtain the most value for their investment. For
example, if the candidate's interval is say 4-6 years and one office has rates
of 93% (sperm recovery) and 70% (pregnancy) for a fee of $3000, and another
office offers convincing rates of 97% and 73% for $5000, then only the couple
can decide whether the increment in higher success is worth the fee
differential. Because
the interval in time (years) between vasectomy and vasectomy reversal
is so important, the first graph below shows the relative numbers of men at each
interval who have experienced sperm recovery (a return of sperm to the semen;
blue columns) vs. no sperm recovery (white
columns). The height of the columns is not the measure of success, but just the
number of patients at each interval. The measure of success at each interval is
the height of the blue column divided by the combined heights of the blue and
white columns. Because of chance statistical variations (6 years just happens to
be a lucky interval for us so far), we predict the likelihood of success at a
certain interval by including the year before and the year after that interval.
For example, to predict success at 6 years, we divide sperm recovery patients by
total patients in the 5-7 year intervals.
* - While Dr. Stein has performed over
1000 vasectomy reversals, the graph
above does not include unilateral (one-side) reversals, repeat reversals, and
patients who have not yet sent in semen samples. Data for unilateral and repeat
reversals is available on request.
** - Notice that the number of patients contributing to
the pregnancy database is considerably smaller than the number of patients contributing
to the sperm recovery database. Almost all patients send or bring in a semen sample
after reversal, so sperm recovery rates reflect the vast majority of patients who undergo
vasectomy reversal. Couples are added as "No pregnancy" only if it has
been one year since the reversal and they have failed to conceive. When we have tried to call our
reversal patients who have recovered sperm, we've gotten all sorts of responses: "the number has been
disconnected or is no longer in service", "no-one by that name lives here", "we're separated", "my husband lost his job and money is tight right
now so I'm back on the pill", "I got a breast tumor and was told that pregnancy could stimulate my cancer if not fully
cured", "we didn't plan on getting pregnant right away, but had you do
the reversal to increase our likelihood of success in a few years"; the list goes on.
Sometimes we learn about a pregnancy of which we were unaware and another
success is added to the data. Sometimes we learn that a couple has been trying
for more than a year but sperm density or motility is very low, and another
pregnancy failure is added to the data. Sometimes we learn that sperm density or
motility is low and the wife has endometriosis or had to have a tube and
ovary removed, and we are not sure whether entering the case as a pregnancy
failure is justified. Or a patient with a perfectly normal semen analysis gets
divorced 9 months after his reversal and his new partner has already had her
tubes tied: can't enter him as a pregnancy failure or success. Thus the many
reasons for the difference in the total numbers of patients included in the two graphs.
In addition, there are no set standards for reporting pregnancy rates.
Some offices will enter a couple as a pregnancy failure only if pregnancy has
not occurred within two years of the reversal, as opposed to one year
as we do. This can make the data "look" better because those couples
not pregnant by 18 months after the reversal would not be included in their data
as pregnancy failures, whereas they would be included as pregnancy failures in
our data. Pregnancy rates will look even better for those offices who do not
include couples as pregnancy failures until three years after the
reversal ... and so on.
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