A vasectomy is a procedure performed on men to render them infertile. Vasectomy involves opening up the scrotum, having the vas deferens suture ligated after being cut, and therefore interrupting the communication of the sperm down the male reproductive tract.
Vasectomies are often performed in couples who no longer want to conceive, and in general it should be done with the purpose of being permanent. There are cases, however, in which vasectomies can, in fact, be reversed. There are times in which a woman decides that she wants to conceive again, and there are also times in which a man is in a new relationship and wants to be able to impregnate his new partner. In those cases the man will see a urologist to talk about how to reverse the vasectomy. This request for reversal only occurs in about 5% to 10% of men.
The procedure involves opening up the scrotum and removing the scarred ends of the vas deferens and re-approximating the two ends together, that is suturing them together to reestablish a communication. The longer the time is from the initial operation of vasectomy to reversal has a direct effect on the efficacy of the reversal. The longer the time has been, the less chance that the actual reversal will be effective. In addition, the older the man, the less chance of getting functional sperm.
Perhaps most importantly, however, is the age of the woman. If a woman is over 35 years old and/or has evidence of reduced ovarian function, it is best that the sperm be taken from the testicle without reversal of the vasectomy. Specifically, in these cases, if the man has no sperm production, but the urologist believes that there is sperm in the testicle, a needle biopsy can be done of the testicle, above the level of the vas deferens, and sperm retrieved. That sperm can be used for in vitro fertilization in the woman.
So again, it is very important to consider the age of the man, the age of the woman, and the time span from the initial vasectomy to the request for reversal.