About Infertility Operations
Our regular microsurgical vasectomy reversal operation (VASO-VASOSTOMY)
has an excellent chance of being successful and results are better
the earlier the reversal is performed, but even pooling all our
4.300 cases up to 30 years after vasectomy, some 85% of all our
couples obtain a pregnancy in the first twenty four months after
the operation. That includes men of all ages with Vasectomies also
of all ages (1 - 35 years). Our regular male infertility bypass
operation (EPIDIDYMO-VASOSTOMY) for the rare cases of men who have
total sterility from natural causes (which are called azoospermia),
as well as those vasectomy reversal cases who need an E-V due to
a damaged epididymis, have a 60% chance of producing sperms in the
ejaculate, but only a 24% chance of a successful pregnancy within
the first three years of operation.
About Sperm Production
Human males produce about 20,000 sperms per minute from each testicle.
These are about 1 micron or 1,000th mm in size. Well over 50 million
sperms are therefore produced each day from each side. It takes
two weeks from production for a single sperm to be pushed along
out of the testicle. They collect at the top of the testicle and
pass into the epididymis.
epididymis is a soft, long, coiled, thin-walled and narrow maturation
tube. It is approximately 70 microns thick (less than the thickness
of a hair) and is surrounded by large thin-walled blood vessels
which act as a heat exchange system in the many weeks it takes to
mature the sperms. This requires a lower than body temperature,
which is why these male organs are located outside the body cavities.
Because the epididymal tubing is about 7 metres long if it could
be measured out along a straight line, it is hardly surprising therefore
that a micron-sized sperm will take over ONE MONTH to travel along
its length. In this time, the sperm matures a strong body and grows
a tail and a tough head. Only then can it function as a sperm. Sperm
leaves the epididymis and enters the vas, which itself is quite
a long tube being 25 cms as it goes from the epididymis, via the
hernial orifice, into the pelvis and down to enter the prostatic
gland at the base of the penis.
vas is wider and more muscular than the epididymis, and is approximately
200 microns (0.2 mm) in internal diameter (about the thickness of
two to three hairs). Usually sperm cells will take a few more weeks
to travel down the vas prior to ejaculation which is done by the
prostate gland. So total time from sperm production to ejaculation
is two weeks (testicle) + four weeks (epididymis) + two weeks (vas)
= eight weeks or more in total. If a man has had a VASECTOMY or
if the epididymis is blocked, he can still ejaculate. However, his
semen does not contain any sperms. Semen is produced by the glands
called the "seminal vesicles" in the pelvis close to the
prostate gland, and functions to carry the sperms along into the
prostate gland in a normal ejaculate.
VASECTOMY, the vas is tied off in the scrotum in order to prevent
sperms passing that point. Until a sperm count proves all the sperms
are now clear of the system following the operation of vasectomy,
contraception must still be practised to prevent conception occurring
from some normal sperms which could be still stored inside the vas
beyond the scrotal ties or in the prostate gland.
production normally continues after vasectomy, and only some of
the sperms are absorbed into the walls of the epididymis and into
the bloodstream around that thin coiled tube, however millions of
squashed sperm cells accumulate every day and can continue being
made until death occurs.
a blockage occurs in the epididymis or vas, there is pressure in
the system and most sperms break down some being removed by the
white blood cells. Most accumulate and the contents of the system
slowly thicken. The production of sperms by the testicle is a very
efficient system which will still work after a vasectomy. We have
confirmed good sperm production in a man 30 years after his vasectomy,
and he fathered a child after his reversal operation.
Hospitals We Operate In.
They have an excellent modern microsurgical operating theatre with
the best available microsurgery equipment, as designed by Professor
Owen. The Hospitals have a quiet atmosphere in a garden suburb,
excellent nursing staff, a good cuisine, and maximum visiting hours.
The Hospitals are used only for elective non-urgent surgical cases
by senior specialists. Professor Owen's operating team have been
together for more than 24 years. Professor Owen does the operation
himself and is assisted by his Assistant Microsurgeon, his regular
anaesthetist and a specially trained nursing team.
OWEN PERSONALLY OPERATES ON EVERY CASE.
It requires a light general anaesthetic, and is NOT painful during
or afterwards. It is performed by our very experienced team of specialists.
The patency of the whole vas is first checked with dye, which will
exit through the urethra. A check is always made to confirm the
production of sperms, after which the tubes are joined together
under the microscope with the finest sutures. If the vasectomy was
originally performed in the right place, the vas, a VASO-VASOSTOMY
will be performed, and takes about one hour on each side. However,
if the vasectomy was performed quite low down in the scrotum, then
it may have tied off the last part of the epididymis, and the only
way to repair this is to perform an EPIDIDYMO-VASOSTOMY, where the
operation joins the epididymis to the remaining vas.
The operation is not painful for the patient following surgery.
patient requires some rest to allow the commencement of proper healing.
After that time he can move about normally provided he looks after
himself sensibly for a few weeks until healing is complete. (No
riding of bicycles, horses, high diving, jogging, sliding down banisters,
etc! - and no sexual intercourse until after healing). It is necessary
to wear an athletic support ("jock strap") at all times
for the month following the operation in order to support the scrotum.
This is to prevent the weight of the testicles pulling on the delicate
vas join. It is also necessary to refrain from intercourse for a
period of one month post-operatively, and during the following six
weeks. CONDOM contraception by the male partner is essential. This
is to prevent possible conception with sperms coming through which
have been previously made under pressure, and which may cause abnormalities
in the unborn child which has not happened yet, as these instructions
have always been followed. Therefore unprotected intercourse must
be avoided, for the first ten weeks post-operation, in our cases,
to be safe.
ten weeks post-operation we require you to have the first sperm
count. That count request can be taken to any Pathologist Collection
office in any country. The result will be forwarded (usually by
Fax) to Professor Owen and you should phone him to discuss the result
a week later (to allow sufficient time for the result to be delivered
to him). If the count is not wholly satisfactory, Professor Owen
will organise a further count several months later and in any case
discuss the progress of the return of the number, motility, and
appearance of the sperms.
Owen is concerned to keep in touch with his patients and follow
up their progress, so please contact this office if you have any
concerns. And please do not forget to inform us of the subsequent
pregnancies and births.