Vasectomy Reversals

When Richard Whiteley had his vasectomy at the age of 35, it was one of those life decisions that he was confident he would never regret. Happily married with two children, he was content and settled in his job as a schoolteacher. He never thought he would consider a vasectomy reversal.

Addressing the problem of male birth control with one anaesthetised snip seemed the ideal solution for the future.

Modern life, though, doesn't always run quite as smoothly as that. With the divorce rate rising and many people getting married again, the number of second families is exploding. Vasectomies undertaken in the glow of a seemingly secure marriage are being lamented like never before. Whiteley found himself in just such a position in his late 40s. His marriage had broken down and he had a new wife, Hilary, 15 years younger than him. They wanted a child together. Suddenly he was seeking ways to regain his fertility.

Which is how he came to be one of the increasing numbers of men who lie on Dr Andrew Dawson's operating table in a clinic in Hartlepool, England, hoping to turn back the clock. Dawson has a growing reputation as a man who can repair broken dreams by successfully reversing vasectomies. When his clinic opened ten years ago, it performed mainly vasectomies. Today his business is almost all reversals – extraordinary testament to a social phenomenon.

The technique used by Dawson, known as the "gold standard", was pioneered in the US and has achieved remarkable success rates.

Vasectomy Reversal Success rates

Based on Dawson's own data collated from the last 517 patients treated at Hartlepool, a man who underwent his sterilisation between one and five years ago has a 94 per cent chance of a successful reversal. With an operation performed six to 10 years ago, the chances are 82 per cent. Even with a vasectomy performed 15 years ago, the success rate can be as high as 80 per cent.

A vasectomy is the cutting or blocking of the vas deferens, the tube that carries sperm from the testes. Reversal is the reconnecting of that passageway. Surgeons have tried many techniques, including the insertion of plastic pipes, protein glue, and laser-guided stitching. But trials have shown that the "gold standard" procedure is reconstruction of the vas with microsurgery.

The inside diameter of the vas is just 0.2mm to 0.4mm, so infinite care and microscopic stitches that do not obstruct the flow of sperm are required to make a reconnection that will be as close to the original as possible.

Dawson, meanwhile, is performing 200 reversals a year. His waiting list now stretches until next February. He believes that the number of people seeking reversals will continue to grow and that in 15 to 20 years there may be a backlash against vasectomy.

"We take a non-judgmental attitude to every patient who comes here, but people's circumstances do change," he says.

"I always ask people if there is anything we (the medical profession) could have said to them at the time that would have made them think again about a vasectomy, but they almost always say 'no'. It was right at the time and they couldn't see the way life was going to be."

Paul Ellis - Men's Health