Phone: (713) 798-4001 | Houston, TX

Jan 13, 2015 — by Larry Lipshultz

A couple in an embrace, the male looking happy and relieved after his vasectomy reversalThroughout his career, urologist Larry Lipshultz has helped many couples fulfill their dreams of expanding their families through vasectomy reversal using the latest, most advanced microsurgical techniques. In some cases, sperm and fluid are still present in the vas deferens at the time of the vasectomy reversal, which allows Dr. Lipshultz to perform microsurgical vasovasostomy. This procedure offers the highest likelihood of sperm returning to the semen, as well as the greatest chance of subsequent pregnancy.

In many other cases, however, an obstruction upstream of the vasectomy site prevents sperm from being present in the vas deferens, precluding the vasovasostomy as a possible technique for vasectomy reversal. In such cases, Dr. Lipshultz can perform the more complex epididymovasostomy procedure. With this procedure, the chances of sperm returning to the semen decrease from 95 percent to 65 percent - still good odds, but not as good as with vasovasostomy.

There is no way to guarantee the success of any vasectomy reversal surgery, and you should be wary of any surgeon who suggests otherwise. Dr. Lipshultz is an accomplished microsurgeon who uses sophisticated techniques and technologies to locate and bypass probable blockages that would prevent sperm from entering the vas deferens in performing epididymovasostomy procedures; nevertheless, even this does not guarantee success. At his urology practice in Houston, vasectomy reversal and no sperm count is a possibility for which he prepares his patients.

Alternatives to Vasectomy Reversal

If sperm cannot be returned to the ejaculate via vasectomy reversal, there are alternative ways to access the sperm and possibly achieve successful pregnancy. These methods include:

  • Microsurgical Epididymis Sperm Aspiration (MESA): This technique involves the removal of sperm directly from the epididymis using a fine needle. The needle is placed through a small incision using microsurgical equipment. This procedure, which can be performed using local or general anesthesia depending on the desires of the patient, is often recommended when epididymovasostomy is either not possible or preferred. It is generally performed in coordination with a fertility clinic so that the sperm can be injected into an immature egg cell (intracytoplasmic sperm injection, or ICSI) as part of an in vitro fertilization (IVF) cycle. Although more invasive than the TESE technique described below, MESA allows Dr. Lipshultz to collect the greatest amount of sperm possible and is generally the preferred approach.
  • Testicular Sperm Extraction (TESE): This technique is similar to MESA except that the needle is placed directly into the testicle to retrieve sperm. For men with severe impairment of sperm production, this may be the most viable method of collecting sperm and achieving pregnancy through ICSI and IVF. It has allowed for the collection of sperm from men who were previously diagnosed as untreatable due to spermatogenic failure.

During your consultation with Dr. Lipshultz, he will fully explain your options and answer any questions you might have.

Learn More about Vasectomy Reversal and No Sperm Count

To learn more about vasectomy reversal with no sperm count, please contact the office of Larry Lipshultz, M.D. today.