Undergoing a vasectomy reversal procedure only to find out that it has failed makes it difficult to think about a second-attempt. Before rejecting the possibility of another attempt at vasectomy reversal, speak with your surgeon about why the procedure failed and what might be different a second time. Most men have vasectomies reversed to have another child. If this is your desire, another vasectomy reversal could be the solution. However, it is important to remember that fertility rates for second-attempt procedures are slightly lower than for first time vasectomy reversal patients.
Schedule an appointment with the surgeon who performed your first vasectomy reversal. Ask specific questions about why this procedure may have failed. How much experience does this surgeon have in vasectomy reversal procedures? Was an operating microscope used? Did the vas deferens have an adequate blood supply? If sperm were not seen in one or both proximal vas deferens, was a vasoepididymostomy performed? Could there now be a blow out or a block of the connection?
Make sure motile sperm were seen at the time of the procedure. Also inquire about options other than vasectomy reversal. Did the surgeon consider any alternative procedures such as microsurgical epididymal sperm aspiration (MESA), percutaneous epididymal sperm aspiration (PESA), testicular sperm aspiration (TeSA), or testicular sperm extraction (TeSE)? These procedures can be done at the time of a second-attempt vasectomy reversal procedure.
You may opt to have only a sperm extraction procedure preformed rather than undergoing a second surgical procedure. While the sperm extraction would recover only a limited amount of sperm, it would be enough for you and your partner to undergo several in vitro fertilization cycles.
Another option to consider before undergoing a second-attempt at vasectomy reversal is to get a second opinion from another physician who performs this procedure. Be sure you have all your records including copies of any photographs or videos which were made during the first procedure. Often another physician will have a new perspective about your particular situation which will aid in making the decision to proceed with a second-attempt vasectomy reversal.
Looking at second-attempt vasectomy reversal procedures, the success rates are slightly below those for first-attempt procedures. Only you in consultation with your physician can make the decision to proceed. Make sure you have all the facts. Get answers to all your questions. This will help you get the most out of your second-attempt vasectomy reversal.