.”
So, Lyttle began looking into what it would take to get her husband’s vasectomy undone.
Doctors who perform vasectomies encourage patients to see the procedure as permanent. However, a reversal is possible through a more involved procedure, with success often determined by the length of time between the vasectomy and the reversal. It can be performed under local anaesthetic in a clinic or under general anaesthetic in a hospital, with the latter having a higher success rate of up to 90 percent in getting sperm flowing again (other factors, such as age, can complicate success in terms of a baby).
New Zealand men have a historical reputation for embracing vasectomies, which are commonly referred to as “the snip “. Present data is hard to come by, but some doctors believe the popularity of the procedure here is increasing, with the number of vasectomy reversals remaining largely unchanged. Data from the US indicates that between two and six percent of patients who get vasectomies will get a reversal.
Dr Gerald Young (right) from CityMed with his team who assists with vasotomy reversals.
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Dr Gerald Young performs about two vasectomy reversals each week under local anaesthetic at CityMed, an Auckland-based clinic. While many of his clients are men who have children from another relationship and want to start a family with someone new, Young has noticed an increase in patients like the Lyttles who about-face on the decision to halt their family’s growth. Before Covid, he had about one of those patients each year. After Covid, he gets half a dozen or so a year.
“You started becoming very family-focused during Covid because you’re locked down and you had limited external contact…
“There are some people that I think [Covid] made them, you know, think about what’s important for them and their life, and I think family is probably a big part for many people.”
Inga and David Stanford are one of those couples. They were sure they were done after three kids of their own, so David flew from Kaikōura , where they run a hostel, to Auckland for a vasectomy. But a joke about having more kids in a conversation between the two sparked a desire in Inga for one more baby.
After some convincing from Inga, David went to Young for a reversal on Valentine’s Day last year.
“The reversal is a hell of a lot more painful and a lot more long-lasting than what the original, you know, getting cut was,” says David.
Within three months, they were pregnant with their fourth child. In January, Inga gave birth to a baby girl.
David Stanford with his new born baby, who was conceived after a vasectomy reversal.
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Inga is 32, and David is in his 60s with two children from a previous relationship, but he is finding fresh enjoyment in what he calls his “second litter”, which is now complete with a newborn.
“They’re an absolute blessing second time around because I’ve got time, I’ve got money and all the things that a lot of young people don’t have.”
In a vasectomy, the vas deferens, the tubes that take sperm from the testicle to the penis, is severed. The ends are essentially cauterised and knotted.
Young’s process for a reversal isn’t all that different from the logic of a plumber. The GP, who has three years of surgical training, first sedates the patient and numbs the area with a local anaesthetic. Then, he locates the severed tubes, removes the scar tissue, flushes the lines and stitches them back together. While vasectomy patients experience a few days of tenderness and can drive themselves home post-procedure, reversal patients must be on full bed rest for a week. The procedure costs about $4000.
Getting a vasectomy reversal under general anaesthesia by a urologist through a microsurgical procedure can cost upwards of $12,000, but the odds of the sperm flowing again can be over 90 percent, says Dr Amir Zarrabi, a New Zealand-based urologist and male fertility specialist. The microsurgical method rejoins the vas deferens across two layers. The powerful surgical microscope used increases the chance of success and enables doctors to look for additional blockages in the testicles.
Dr Amir Zarrabi, a male fertility specialist.
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The testicles still produce sperm after a vasectomy, and pressure can build up, causing a “blowout” in the epididymal tube, says Zarrabi. In that case, a highly technical repair is required.
“The tubes that you work on there in that part of the testicles are not even the width of a human hair,” says Zarrabi.
There is a 40 percent risk of an epididymal obstruction if the reversal is done within five years of a vasectomy. That risk increases to 75 percent if a decade has passed.
Dr Giovanni Losco, a urologist in Christchurch, does about half a dozen reversals a year, with cost being a major prohibitive factor.
“It’s not a procedure which is funded in the public health system. It’s not a procedure which is funded by private insurance because it’s considered a choice, a discretionary procedure.”
The main competitor to a vasectomy reversal is IVF, says Losco. In that case, a surgical sperm retrieval from the testicles is done without the need to rejoin the vas deferens.
Because many of Zarrabi’s reversal patients want to start a second family with a new partner, that female partner might be older, which can complicate the end goal of producing a baby, he says. Fertility in females drops around the age of 40.
“If it’s a female above the age of 40, and the male had his vasectomy 20 years ago, then I would usually tell them, ‘Listen, you’re probably going to have more success with IVF’.”
When Lyttle’s youngest child turned four, her husband went for a vasectomy reversal in March 2022.
“He was in bed for a week, I’d say. He wasn’t comfortable. There was quite a bit of swelling…”
A test after three months let them know the sperm was flowing again. In August 2023, Lyttle had her third baby.
“I think the whole postpartum period is probably not the best time to decide [to get a vasectomy].”
