Some men will develop antibodies to their own sperm after vasectomy – these antibodies may be in the blood only or also on the sperms themselves. It was previously thought that once these antibodies had been formed, the sperm would forever be non-functional. Scientific studies have, however, proven this perception to be completely untrue. Testing for anti-sperm antibodies at the time of vasectomy reversal is not done, simply because it does not influence the management or the outcome. While antibodies may cause problems in some patients, they are clearly not responsible for most cases of post-vasectomy reversal infertility.
Before the use of microsurgical techniques that made vaso-epdidymostomy possible, a long time interval since the vasectomy was seen as a very bad sign. This has all changed dramatically. International studies consistently show that good success rates can be achieved by skilled and experienced Urologists using microsurgical techniques, even when many years have passed since the vasectomy. Although success cannot be guaranteed, there certainly is sufficient scientific proof that vasectomy reversal many years after vasectomy is a viable option. It is very important to remember that these good results can be expected if your Urologist is able to perform microsurgical vaso-epididymostomy, as this is often required in cases where many years have passed since the vasectomy. Speaking of long time intervals since vasectomy: people often think that men will stop making sperm at some stage after vasectomy – this is completely untrue.
No and No.
In most institutions a single cycle of infertility treatment will cost more than the entire vasectomy reversal procedure, and most women will need more than one cycle of fertility treatment. The chances of success of IVF is only about 35% per cycle. If a female undergoes enough cycles of IVF, the eventual success rate in achieving pregnancy is as good as for vasectomy reversal – the cost, however is 3 times more.
Vasectomy reversal involves a single operation on the male partner, IVF requires the female partner to take hormonal drugs, have eggs harvested from her ovary, have the embryos implanted into her uterus a few days later and then have regular follow-up appointments to monitor for success. It is a time consuming process and the uncertainty of success often an emotional rollercoaster ride for the couple. Additionally, for IVF the male partner also needs to undergo a small surgical procedure where sperms are harvested from the testicle with either a needle or a surgical blade.
A word of caution: if your Urologist is not using microsurgical techniques and an operating microscope when performing vasectomy reversal surgery, then IVF may well be the wiser option.Up to 60% of males undergoing vasectomy reversal will have epididymal obstruction and in these cases you need a microsurgical vaso-epididymostomy. A simple vasovasostomy will not address the area of blockage and will be a waste of your time and money.
In South Africa, microsurgical vasectomy reversal surgery is not taught at Universities and hospitals which train Urologists.Some Urologists will offer this service, but it is not known if they received additional formal training for this. And we haven’t even started talking about them using microsurgical techniques! A Urologist offering vasectomy reversal should have the knowledge, skill and equipment to do a meticulous (2 layers, watertight) re-connection of the vas deferens and also perform vaso-epididymostomy if intra-operative findings necessitate it. For this, an operating microscope and formal microsurgical training is essential. I received advanced microsurgical training at the Cleveland Clinic in the USA, as well as with internationally renowned microsurgery experts at Weill Cornell Medical School in new York.
This is variable.
The return of sperm after vasectomy may be immediate or may take up to 12 months. Factors that may influence this include the intra-operative sperm analysis (whether I see fast “swimming” sperm or only sperm with limited mobility) and the type of re-connection required: cases where vaso-epididymostomy are required on both sides often take long to have sperm restored to the ejaculate. I advise routine semen analysis to be done at 3 months, 6 months and 12 months after the surgery.
Many different factors determine success after vasectomy reversal, of which the skill of the Urologist is only one. The genetics and physiology of every man who comes to me for an operation are unique. These determine for instance the amount of scar tissue that he will form at the site of the reconstruction. So even if a very meticulous and technically sound surgical procedure is carried out, factors like these will invariably affect the outcome to some degree.
The first step would be to contact me to set up an initial consultation.
During your first consultation I will take a medical history, find out about any other illnesses or chronic medication, do a limited physical examination and discuss the details of your procedure. Your wife / partner is welcome to join you for this visit and I will do my best to answer all the questions that the both of you may have. We will also set a date for your operation and you will receive the necessary practical information about the hospital as well as do’s and don’ts before your surgery. You should leave my consulting room feeling informed, confident and at ease.
Our next meeting after that will be in the operating room on the day of your surgery. (See “Procedure”)
Good day Dr Zarrabi I hope you are keeping well. It has been 10 months since we did the Varicocele repair and a lot has happened since then and obviously it’s been quite a journey. But needless to say it was not all in vein. Hence my e-mail to you today. If you recall we went back to the Aevitas about August for one last Invitro (6th). The result was that we had a better count and better mobility due to the Varicocele repair as what we ever had before with the previous 5 Invitros. And I am very pleased to announce that E had a successful/positive result and she is 3 and half months pregnant now. We would just like to express our Sincere Gratitude to you and your staff for all your assistance and prayers through the whole process. Kind regards,
We want to thank you and Dr Zarrabi for being kind and gentle…. There is such a huge difference in patient care, follow-ups and bruising between the previous Dr and Dr Zarrabi’s offices. I thank God that we went to your practice and I will let you know if there is a little heart beat inside of me… Lots of Love.
Good day Dr Zarrabi Trust you well. I just wanted to say thanks very much for your professionalism and great help on my husband’s operation. Today I have a very healthy active 9 month old son thanks to you. At one stage we had just given up because nothing happened but then this miracle came along. Keep up the great work. Thanks and regards,
Dear Dr Zarrabi We have the best, if not surprising news, 'M is PREGNANT!!! She been feeling funny in the latter part of August as I was starting my course of prelox. We are overwhelmed and overjoyed. Thank you, thank you so so much.
Good morning Gillian I just want to send you this email to say a big thank you for all your assistance in making our trip a success. We are safely back home and everything with M is going great so far. Dr Zarrabi really is the best! I will keep you posted on any further developments. Thank you kindly and have a blessed day.
Hi Doctor Baby girl YP was born on the 12th of April 2017. You do amazing work and she turns 3 months old tomorrow. See pics attached… Regards
Dear Dr Zarrabi A and I feel truly blessed to have been able to have this reversal done by Dr Zarrabi. The fact that he is able to even perform an operation of this nature is truly amazing and we are fortunate to have somebody in South Africa that has the skillset to perform Micro surgery reversals. I imagine it must be very rewarding to make such a positive difference in people’s lives. In addition to this we found it to be easy and hassle-free to undergo the surgery in spite of the fact that we live more than 1500 kilometres away. Thank you for the professional, efficient and friendly way that you assisted us throughout this process. I will be sure to let you know as soon as A is pregnant (she may already be). Once again thank you.
Good day Dr Zarrabi Thank you so much to You and your Staff. We (my Wife) recently did a blood test; and it came out positive - that she is pregnant. Thank you soo much Dr Zarrabi; thank you for helping us in our journey.
Thank you so much, doc I truly appreciate all your support and valuable information. I hope your stay in the USA is amazing, you have been the most amazing medical professional i have ever dealt with and I'm extremely grateful that you've helped me all along. Kind regards,
Good day Dr Amir / Gillian and Team I hereby would like to thank you all for the excellent and friendly service we received. Everyone on the doctor’s staff was professional and efficient, they made me feel at ease in a stressful situation. I felt that I made a good choice in coming here and, as a group, each of the staff members cared for me and wanted to help me get better. I was thoroughly impressed with the facilities and services at the hospital. Everyone knew what needed to be done, at what time and did it with a smile and compassion. Any questions that myself or wife had was answered quickly and with a friendly disposition. In closing, I would like to thank you for all that you did even after I was dismissed and had a little complication Dr Zarrabi assisted and was ready to take action. It is professionals as yourself and facilities like your hospital that made me decided to use you from the beginning. Regards,
Dear Dr Zarrabi We are not sure you will remember us, amongst all your clients! D and I came to see you in November 2013 for a vasectomy reversal procedure. You were a little concerned that his vasectomy was 15 years in the past and he was 55 at the time. We visited your practice this month while in Cape Town for the first scan of our expected little one - we wanted to share the good news with you! We did conceive within 3 months of the procedure but had an early miscarriage and what with the ups and downs of life over the last 2 years didn't get this far until now. SO - D is in peak condition and our baby is due on Christmas day this year. Thank you so very much for all the microsurgery and D says please send him 1000 business cards to hand out wherever he goes! We will send you a picture of the three of us for your collection when baby is born. With heartfelt gratitude and deepest thanks.
Dear Dr Zarrabi We are writing to you to thank you for your amazing care, concern and professionalism. Since meeting you we have has such a wonderful experience working with you. Thank you for everything!! It is greatly appreciated. Wishing you a good evening. With gratitude,
Hi Amir Hope all's well on your side. I am pleased to announce that L is pregnant - exactly 1 year to the day of the reversal! We had it confirmed with a blood test today. We just thank you for your skill and optimism. Just interested to know... Have we set a new record for length of time between vasectomy and reversal: 18 years ;-) thanks again to you and your team. Cheers D.
Liewe Dr Zarrabi Ons wil u net graag in kennis stel dat die prosedure wat u gedoen het suksesvol was. Ons moes nog gaan vir die sperm analise, maar ons het vroeër uitgevind ons is swanger. Ons is nou 6 weke swanger, en wil u net baie hartlik bedank vir die suksesvolle operasie. Baie Dankie
Hallo Dok, Lyk my jou operasie was ‘n reuse sukses. My vrou is nou 11 weke swanger. Dit het ons dus so 1 jaar en 3 maande geneem om swanger te raak. Groete,
Hi Amir Weereens baie dankie vir jou hulp! Dit was n great ervaring! Baie profesioneel! World Class!! Groete
Dear Dr. Zarrabi, Hope you are well. I just want to say thank you for a fantastic service and care I received. It was nice to chat with you first and it made me feel like I am in the right hands. The staff in the clinic were also great. Warm and kind and understanding. A service that stands out compared to other clinics or hospitals where nobody comes to check on you and you never see anybody around.
Hallo Dokter Zarrabi Ekt gister met my sussie en swear ‘n koffietjie gedrink en hierdie ‘great’ storie gehoor van hoe u hulle hanteer en versorg het. (eintlik gebless het!) My mond het oopgehang, want mens hoor dit min. Dankie Dokter, ek eer en respekteer jou daarvoor. Alle sukses met jou praktyk en drome vorentoe. Vriendelike groete
Hello Dr. Zarrabi, It has been a hectic couple of months. I have great news, M is 11 weeks pregnant and to top it off I didn’t even go for the sperm test. We found out the week that the test was scheduled. Thank you! You have worked miracles we never in our wildest dreams thought that it would happen so soon. We will keep you updated as the pregnancy progresses and might even come introduce the little one next time we are in Cape Town. Regards
Dear Dr Zarrabi, Many thanks to you and the gift that you have given to me. I really wish that I were in Cape Town to celebrate with you. Thanks once again for your great skill and miraculous hands.
Hi Doc, Just a quick email to share our wonderful news - we are pregnant!!! We can't thank you enough for all you have done, and not giving up when most doctors probably would have just shrugged their shoulders. I know you were a tool in the Great Healer's hands, but nonetheless, a BIG thank you!! Can't wait to send our updated family picture. Have a wonderful, blessed day!
Dear all, After much soul searching, S and I decided to reverse his vasectomy and try naturally before resorting to other options. S had his vasectomy reversal done by Dr Amir Zarrabi. We never got to do the 6 month sperm test as I had fallen pregnant. The pregnancy was uneventful and our son was delivered at 39 weeks.
Hi Dr, Thank you so much for this report!! I am in tears right now, I did not even realize how much I was stressing about this until I got your e-mail!! You really have made this year the best one ever and we will highly recommend you to anyone we can. Your support and complete handling of our case including your after service has been so amazing! We are both so grateful to you. Kind regards,
Dear Dr Zarrabi This letter is long overdue…but for a very happy reason. My wife and I would like to express our heartfelt appreciation for the efforts you made and the application of your considerable skill in reversing my previous vasectomy done 13 years ago. Before proceeding with the surgery you fully explained what we could expect in terms of a timeline, and we complied with all the steps along the post-surgical way. As per your instruction we were supposed to have a sperm analysis done 3 months after the operation but when my wife missed her date we knew something was going on and I didn’t even have to go for the sperm test. We were ecstatic to learn that the surgery was successful and that I was once again delivering viable “swimmers”! We are now 12 weeks pregnant and all thanks goes to you. Doctor we are so blessed to came across your information on the website just when we were at our lowest. We have been through ICSI twice, as we thought it would have a better chance of success. With even everything as normal and positive as could be both sessions was unsuccessful. It costed us a fortune and we didn’t realize that if we did our homework properly the first time, we could had our baby in our arms right now. That is why we are extremely thankful that you have done such a great job. We never doubted you once…we just knew this was it. Words are a poor conveyance of the gratitude we feel, but please accept them with the knowledge that you have made us very happy as a result of your outstanding skill and diligence. Warmest regards,
Hi Doctor Amir, We hope that you and your family had a wonderful Christmas and new year. We have some wonderful news, D is pregnant!! This miracle was conceived naturally!! She is just over five weeks today and we are both over the moon. We would like to thank you again for all that you have done for us to make this miracle happen! We will keep you updated. Kind regards,
Dear Dr Zarrabi, As you can see from the attached pics, our 2015 started off extremely well, all thanks to you... KL was delivered via c-section at 08:31am on Friday the 2nd Jan 2015. Weighing 3.22kg and measuring 51cm. She is gorgeous! I'd like to extend a very big thank you to you and your staff for making our dream come true. A is thrilled to be a big sister. Take care and best regards,
Good day Dr Zarrabi We are happy to announce the birth of our baby girl TH. She was born on the 4th of February 2015 weighing 3.350kg. This was a miracle to us. We would like to thank you for making our dream come true by resulting in a successful vasectomy reversal on my husband G in October 2013. Thank you so much doctor!