Reversals at The Turek Clinics
With Reversal Specialist Dr. Turek, the vasectomy reversal success rate is 100%, when moving sperm are found behind the vas deferens during vasectomy reversal surgery. This means that all patients will have a return of motile ejaculated sperm when motile vasal sperm are found at surgery.
As one of the top experts in the field, Dr. Turek has written and published on the success rates of men with vasectomy reversal surgery.
With vasectomy reversal surgery, there are two success rates to consider:
- Patency Rate – Return of moving sperm to the ejaculate after vasectomy reversal
- Pregnancy Rate – The successful attempt to have a baby.
Dr. Turek’s Vasectomy Reversal Success Rates
Dr. Turek’s expertise and success in vasectomy reversal procedures is unparalleled in his field as his published success rates show.
Patency Success Rate
The patency success rate is the rate that best reflects the surgical decision-making knowledge and skill during vasectomy reversal, and should be considered carefully when evaluating a microsurgeon. Dr. Turek has advocated in his research publications that patency rate be should be defined as the presence of moving or motile sperm (not just dead) sperm in the ejaculate after vasectomy reversal. This is because dead or non-moving sperm could simply be the “wash out” of old sperm in the system and therefore may not indicate that the system is actually “patent” or working after vasectomy reversal. In addition, since only motile sperm will lead to pregnancy, this measure makes the most sense to assess. Be sure to ask your surgeon exactly how they measure patency rate after vasectomy reversal and whether these rates are from their personal experience with the technique.
Ways to Assess Vasectomy Reversal Success Rates
To get a better sense of the true quality of Dr. Turek’s procedural skills, it helps to look at the patency success rates in several different ways: (1) the results over time after reversal (Figure 2), (2) the results in the best possible setting—when moving sperm are found at the testis vas deferens during vasectomy reversal (Figure 3), and (3) the results based on the age of vasectomy at the time of reversal (Figures 4, 5).
Achieving Sperm With Time
Figure 2 illustrates the fraction of men who achieved motile sperm in the ejaculate with time after vasectomy in Dr. Turek’s recent vasectomy reversal case series. Notably, 95% of men with a vasovasostomy show motile sperm in the ejaculate within 1 year after vasectomy reversal. Interestingly, almost 80% of these men achieve motile within 3 months of vasectomy reversal.
The vasectomy reversal rate for epididymovasostomy is different, however, for several reasons. First, fewer men will eventually achieve motile sperm counts (62%) and the time to achieve motile sperm counts after epididymovasostomy takes longer than it does for vasovasostomy. This vasectomy reversal rate likely reflects the natural biology of recovery from long term obstruction after vasectomy reversal.
Achieving Sperm in the Best Possible SettingDr. Turek’s vasectomy reversal rates in the best possible setting are illustrated in Figure 3. Notably, when moving sperm are found at the vas deferens during vasectomy reversal, 100% of Dr. Turek’s patients have successful patency (motile sperm) within one year after vasectomy reversal. When non-motile sperm are found, Dr. Turek’s patency success rate is 94% at 1 year after vasectomy reversal. Dr. Turek has also published that:
- The age of the patient at the time of reversal matters little to patency success rates. Using different age cut-offs, including <35, 36-45, and > 45 years old, no differences in patency success rates were detected after his vasectomy reversal.
- If the vasectomy is ≤ 8 years old, then there is a faster return of motile sperm to the ejaculate after vasectomy reversal compared to older vasectomies. At the end of 1 year, however, the overall patency success rates after vasectomy reversal, however, did not differ between these groups.
Finally, his published experience in reversing “older” vasectomies (>15 years after vasectomy) shows that extremely high patency rates are possible (75-90%) despite the need for more complex procedures to successfully reverse the vasectomy.
Achieving Sperm Based on Vasectomy Age
A third way to examine patency success after reversal is to examine how the return of motile sperm to the ejaculate changes with vasectomy age. This approach takes into consideration the likelihood of epididymovasostomy during reverse vasectomy, as this technique is generally associated with lower patency success and pregnancy rates than vasovasostomy.From Dr. Turek’s published experience, the chance of needing an epididymovasostomy is 3%/year for every year after 5 years of vasectomy age (Figure 4). Thus, a 10-year-old vasectomy has roughly a 5 x 3%=15% chance of needing an epididymovastomy. A 20-year-old vasectomy has a 15 x 3%= 45% chance of epididymovasostomy (details on his published study). Interestingly, breaking with the dogma in the field, Dr. Turek’s most recent research has shown that this trend toward higher rates of epididymovastomy with increasing vasectomy age appears to “flatten out” after 20 years of vasectomy age (Figure 4). In other words, the need for epididymovasostomy during reversal of older vasectomies does not continue to rise but remains stable. This is good news for men with older vasectomies, as they are may not necessarily need an epididymovasostomy at the time of reversal. Read the news coverage that summarizes Dr. Turek’s recent research. Dr. Turek has also published his vasectomy reversal patency success over the entire range of vasectomy ages, from 1 to 38 years of age. As Figure 5 shows, excellent patency rates (gray bars) can be achieved in vasectomies of all ages. Similarly, he showed that sperm output after reversal of vasectomies of various ages is relatively unchanged when examined over the full range of vasectomy ages. This means that regardless of how old the vasectomy is, sperm production remains high and constant after reversal.
Dr. Turek’s Pregnancy Success Rates
The pregnancy success rates after vasectomy reversal depend not only on the patency rate, but also on known or unknown female factor issues, including female age. Among Dr. Turek’s couples, the average female age in a case series analysis was 35.5 years and the average interval from vasectomy to vasectomy reversal was 13.5 years. Among men with vasovasostomies on both sides, 56% of partners became pregnant within 1 year of vasectomy reversal. Among men with a vasovasostomy on one side and epididymovasostomy on the other side, 52% achieved a pregnancy within 1 year, and among men with epididymovasostomy on both sides, 40% achieved a pregnancy by 1 year after vasectomy reversal. Importantly, these rates did not include pregnancies that occurred after the first year, which if included would make these rates even higher. Also, these pregnancy success rates are impressive given the age of the vasectomies in Dr. Turek’s published series and the relatively advanced maternal age of the female partners. What Dr. Turek has observed is that most pregnancies after vasovasostomy tend to occur in the first year after vasectomy reversal and many pregnancies after epididymovasostomy occur between years 1 and 2 after vasectomy reversal. This is helpful information for couples as they plan their family building goals after vasectomy reversal.
Dr. Turek has an international reputation as a fellowship-trained microsurgeon and performs vasectomy reversals weekly. His experience with the technique is published, as are several innovations that he has described. He has trained over 50 urology residents, fellows and practicing urologists around the world in this technique. In Dr. Turek’s practice, 33% of the patients he sees have a second obstruction that requires bypassing (epididymovasostomy) and 15% of his cases are patients who have failed previous vasectomy reversals with other surgeons. Most of his cases are referred by urologists who do not feel comfortable performing a vasectomy reversal on men with older vasectomies because of the high likelihood that an epididymovasostomy will be required. Dr. Turek is also comfortable tackling men with traumatic, infectious or congenital conditions that require microsurgery. Because of this experience, and his skill as a master surgeon, his complication rates are extremely low and his success rates are very high.
Another way Dr. Turek measures the success of his vasectomy reversals is the happiness of the families that he helped to create: Vasectomy Reversal Patient Stories