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Most fertility specialists and family planning agencies encourage men to consider vasectomies a permanent contraceptive procedure. The orignal vasectomy procedure is relatively straightforward and minimally invasive. A doctor may use a local anesthetic to desensitize the scrotum, then make two small incisions to reach the vas deferens - the tube which tranmits sperm from the testicles. The two vas deferens are pulled through these incisions and a surgical slice is made. The ends of the tubes may be cauterized with heat, tied off with sutures or held shut with tiny surgical clamps. The result is sterility, since sperm cells from the testes can no longer enter the reproductive process.
Reversing this relatively straightforward procedure, however, is not so simple. Surgeons who perform vasectomy reversals receive special training in the process and are in great demand. Scheduling an appointment with a vasectomy reversal specialist may not be easy, and the cost of the surgery itself can run from 3,000 to nearly 18,000 US dollars. Those seeking such an expensive operation should first consult with their medical insurance company to determine if the procedure is covered. Some insurers encourage contraceptive surgeries but are reluctant to pay for their reversals unless proven medically necessary.
The vasectomy reversal surgery itself requires a general anesthesia and can take at least an hour and and a half to perform. Surgeons often work with microscopes to see the tiny vessels which need to be reattached. In some instances, the original vasectomy cannot be successfully reversed because of the procedure used or the amount of time that has elapsed. Some men develop antibodies which attack sperm cells, which means the number of usable sperm may still be too low for fertilization after the reversal. Vasectomy reversals do have a significant failure rate, so patients need to be prepared for any outcome.
Some men who choose vasectomies will have some of their sperm cryogenically frozen before the operation, in case they change their minds about fatherhood in the future. This process has indeed made vasectomies a more appealing contraceptive option, but a percentage of the donated sperm cells do not survive the ordeal of freezing. Vasectomies are cheaper and less difficult than female tubal ligations, but can be just as problematic to reverse. For this reason, vasectomies should generally be considered permanent and irreversible unless other life circumstances make fatherhood a viable option again.
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