By Dr. Jason Kovac, Posterity Health
If you’re considering a vasectomy reversal, you’re likely focused on a singular goal: your chances of success.
A vasectomy reversal is often a deeply personal decision tied to the goal of growing your family.
What many men don’t realize is that not all surgeons performing vasectomy reversals have the same training, experience, or microsurgical expertise.
As a reproductive urologist, I can tell you that vasectomy reversal is one of the most technically demanding procedures in male reproductive medicine. The success of the surgery often depends on factors such as the surgeon’s training, experience, and ability to perform complex microsurgical techniques when needed.
Before scheduling your procedure, here are seven important questions every patient should ask.
1. Are You a Board-Certified Urologist?
This is the first question I would ask.
Board certification means that a physician has completed specialized training in urology and met rigorous standards established by the American Board of Urology.
A vasectomy reversal involves delicate structures within the male reproductive tract. Patients should be sure that the person performing their surgery is a physician with formal training in urologic surgery.
2. Do You Have Specialized Training in Male Fertility or Reproductive Urology?
Not every urologist specializes in male fertility. Every physician at Posterity Health is a reproductive urologist and we’ve completed additional training focused on male infertility, microsurgery, hormone management, sperm production, and fertility restoration procedures.
This specialized expertise can be really important when a reversal requires more than simply reconnecting the vas deferens.
Research shows that fellowship-trained male infertility surgeons are more likely to perform advanced microsurgical techniques and routinely use operating microscopes compared to non-specialists.
3. How Many Vasectomy Reversals Do You Perform Each Year?
Don’t be shy about asking a surgeon about his or her experience because it matters.
Vasectomy reversal is not a procedure most urologists perform frequently. In fact, an analysis of American Board of Urology case logs found that relatively few urologists perform large numbers of reversals. Ask your surgeon:- How many reversals do you perform annually?
- How long have you been performing them?
- What percentage of your practice is dedicated to male fertility and microsurgery?
4. Do You Use an Operating Microscope?
A vasectomy reversal is a microsurgical procedure.
The tubes being reconnected are only a few millimeters in diameter. Surgeons use specialized microscopes and ultra-fine sutures to reconnect these structures with precision.
Studies have demonstrated that microsurgical vasectomy reversal can achieve excellent outcomes when performed by experienced surgeons.
5. Can You Perform a Vasoepididymostomy if Necessary?
Many patients are unfamiliar with this term, but it can be one of the most important questions you ask.
During surgery, some men are found to have a blockage beyond the vasectomy site. In those situations, a standard vasectomy reversal may not work.
Instead, the surgeon may need to perform a more complex procedure called a vasoepididymostomy.
This operation is technically more challenging and requires advanced microsurgical expertise. Not every surgeon who performs vasectomy reversals routinely performs this procedure.
6. What Are Your Success Rates?
Ask for specific numbers.
A qualified surgeon should be able to discuss:
- Patency rates (the return of sperm to the semen)
- Pregnancy rates
- Outcomes based on how long ago the vasectomy was performed
Large studies of microsurgical vasectomy reversals have reported patency rates exceeding 85%, with outcomes influenced by factors such as the time since vasectomy and the need for more complex reconstruction.
Remember that success rates vary from patient to patient, but your surgeon should be transparent about their experience and results.
7. What Is Your Complication Rate?
Every surgery carries risks. Ask about complications such as:
Bleeding
Infection
Chronic discomfort
Need for additional procedures
Published research on experienced microsurgical surgeons has shown relatively low complication rates, with outcomes improving as surgical experience increases.
Why Training Matters
One of the biggest misconceptions about vasectomy reversal is that it is simply “undoing” a vasectomy.
In reality, the procedure often requires complex decision-making, advanced microsurgical skills, and the ability to pivot during surgery if we encounter an obstacle.
The surgeon may need to determine whether sperm are present, identify blockages, choose between different reconstruction techniques, and perform delicate repairs under high magnification.
That’s why many patients seek care from board-certified reproductive urologists who have dedicated a significant portion of their training and practice to male fertility and microsurgery.
The Bottom Line
Choosing a surgeon for your vasectomy reversal may be one of the most important decisions you make during your fertility journey.
Don’t be afraid to ask questions about training, experience, success rates, and surgical approach.
Your ultimate goal is to maximize your chances of restoring fertility and get the best outcome possible that matters most: building your family.
Frequently Asked Questions
Who is the most qualified doctor to perform a vasectomy reversal?
A board-certified urologist with specialized training in male infertility and microsurgery is often the most qualified provider to perform vasectomy reversal surgery.
What is a reproductive urologist?
A reproductive urologist is a urologist who specializes in male fertility, hormone disorders, microsurgery, vasectomy reversals, sperm retrieval procedures, and male reproductive health.
Does surgeon experience matter for vasectomy reversal?
Yes. Vasectomy reversal is a technically demanding microsurgical procedure, and research suggests that outcomes improve with specialized training and surgical experience.
Does surgeon experience matter for vasectomy reversal?
Yes. Vasectomy reversal is a technically demanding microsurgical procedure, and research suggests that outcomes improve with specialized training and surgical experience.
What questions should I ask before a vasectomy reversal?
Ask about board certification, fellowship training, annual procedure volume, use of an operating microscope, ability to perform vasoepididymostomy, success rates, and complication rates.
Is a vasectomy reversal considered microsurgery?
Yes. Vasectomy reversal is a microsurgical procedure that involves reconnecting structures only a few millimeters wide using specialized instruments and magnification.
Dr. Jason Kovac
Dr. Jason Kovac is a fellowship-trained Reproductive Urologist. He serves as the Regional Medical Director for Posterity Health in Indiana, Ohio, and Michigan. He is a dual board-certified Urologist in both the United States and Canada.
Dr. Kovac obtained his MD and Ph.D. from the University of Western Ontario. He completed his urology residency at McMaster University in Hamilton, Ontario, and completed his Fellowship in Male Reproductive Medicine and Surgery at the Baylor College of Medicine in Houston, TX where he focused on male fertility and sexual medicine. During his time in Houston, Dr. Kovac worked closely with the originator of the modern vasectomy reversal, Dr. Larry Lipshultz, and Dr. Dolores Lamb, a pioneer of male fertility research.
He is board-certified by the Fellowship of the American College of Surgeons (FACS) and the Fellowship of the Royal College of Physicians and Surgeons of Canada (FRCSC).
Dr. Kovac is a trailblazer for male fertility research, and has led multiple clinical trials on male fertility, scrotal pain, and hormone management techniques, and continues to lead similar research efforts.
If you have questions not covered here, or if you are ready to schedule your male fertility workup we’d love to hear from you. Call us at (888) 538-4185 or complete our contact form to get started.