So this is our story of a vasectomy reversal and subsequent pregnancy.
In February 2010, my husband had a reversal from Dr. Cary Leverett in New Braunfels, Texas. He is one of a few low-cost reversal providers in the US- he preforms them out of his out-patient clinic and under local/concious sedation, so that keeps costs down. He and his staff were awesome. He provides this service as part of his Christian ministry -he belongs to a church that doesn't believe in sterilization- but does not discriminate against patients who have different religious beliefs, and isn't really overbearing with it or anything. His staff is awesome and very kind and helpful. I was really happy with the whole experience with them. It was $3000 total, with a $500 deposit due to schedule it. They are also open to working with you and making installments before your surgery date. His website is here: http://www.reversals.com/about.html
I HIGHLY recommend finding a specialist who ONLY does microsurgical reversals, as opposed to just finding a urologist to do it. This is a very very delicate procedure preformed on a tube of tissue smaller than a strand of angel hair pasta. You want someone who does this and only this. Look for someone who only does 2-3 reversals a day, and who has been certified in microsurgical technique (ie, didn't just take a class over the weekend). Being published is good, having their results published (as Cary Leverett's have) is GREAT. There is another low-cost surgeon in Oklahoma, and two vas reversal centers that I also looked into in Arizona and New York. I chose Leverett because my family lives nearby so we could stay with them while he recovered, and because I liked his website the best and he had what I was looking for in terms of professional experience, training, and technique.
If you're looking into a vas reversal, you are probably despairing over the 50% sucessful statistic. I cannot tell you how many sleepless nights that number caused me. That is VERY outdated and is not representative of the new microsurgery techniques. The odds of having sperm return to the semen (patency) after a reversal now is more like 90%, and the odds of pregnancy are around 75% within two years. This can be very variable. It depends on what kind of vasectomy your husband had (if they only cut the vas defrens vs. cauterizing or knotting them), what his internal anatomy is like (if he has longer vs. shorter tubes), how long ago it was, how fertile YOU are, and what kind of health you are both in.
To give you an idea, my husband was on the lower end of the "ideal" scale. He was over 40, the vasectomy was 8 years old, he's overweight, and he had a cauterized vas. However, the surgeon told us to be very hopeful, that he had minimal scar tissue in the tubes, and that he thought our chances of conception were good. Additionally, I'm 20 years younger than he is, and fertile as a rabbit. So that gave us a good reason to hope.
His recovery from the vas was complicated. He didn't have very much post-surgical pain and said the procedure itself was much less painful than the original vas. However, once he went back to work (he's a computer repairman for a hospital so he's up and down and walking up stairs all day) he got VERY severe swelling and bruising. We're talking two grapefruits hanging halfway to his knees here. He took 1000mgs of ibuprofen 3 times a day, lots of Vitamin E to prevent scar tissue, applied arnica gel basically from his thighs to his belly button, and we made a sling out of a towel to prop his testicles up so that the fluid could drain. He kept ice on them almost continually for about six weeks. He was back to normal within two months. However, this was very unusual and likely due to my husband's other health problems (autoimmune disorders and being overweight) and his physically strenuous job. Most men are back to their normal activities within two weeks. If you need to, this surgery qualifies under FMLA if he needs the time off. Contact the HR department directly *before* he has surgery to arrange things. If his boss is being a dick about giving him light duty or time off, going in his office in person and crying about how if he doesn't recovery well from this surgery it will ruin your chances to have a family works well. =P Also, make cookies or something for his coworkers who are picking up the slack. They were suddenly more cheerful about having to lift all the boxes after I made chocolate chip oatmeal cookies and butter pecan brownies.
We waited about nine months before TTC- I got a Mirena IUD two months before the vas so I could adjust to it and make sure it would work for me before we would need to worry about birth control. I had the IUD removed in September.
We conceived on our second cycle of trying- I had one right after I got the IUD but it was very scanty (probably from the Mirena keeping my lining thin, it hadn't built back up yet), and then on our second one I was out of town during ovulation, and then on my third cycle- Big fat positive!
I NEVER thought I would conceive so quickly. We didn't get a sperm analysis done, since there wasn't even really anything we could do at that point- we couldn't afford IVF or any kind of assisted reproduction, so I didn't want to bum myself out if it was bad. I just took my prenatals, charted my cervical discharge to see when I was ovulating, and timed intercourse, and then WHAM. Pregnant! On the SECOND TRY!
One nice side effect of the reversal is that it's MUCH easier for him to climax now. So if you're trying to wheedle your guy into going under the knife, that might be a positive for him! *winkwink*
We thought a lot about whether we should get a reversal, or a sperm donor, or do some kind of sperm retrieval. For most people, the reversal is the easiest and cheapest way to go. Even if the sperm count is low, you get WAY more sperm per cycle just being able to have intercourse every other day in your cycle than you ever would through ICSI, or from a one-time artificial insemination. You also get more chances to try- for free! It was also important to me to feel like we did this the normal, natural way. Having to go in a doctor's office for hormone treatments and lots of needles and things just didn't seem like as much fun. And I wanted to have my husband's baby. I would have paid ten times as much money for this experience. It's worth the money. It usually works.
Additionally, if the reversal didn't really "work", most surgeons will go back for a reduced fee and repreform it. This is still usually better in terms of successful conception and cost-effectiveness than going to IVF. They can clean out scar tissue that may have formed, or directly attach the far end vas defrens to the epidyimus, where the sperm is made. Sometimes a "blowout" occurs where the epidydimal side of the vas has ruptured, and that portion of the tube is no longer viable. The success rate for that is the same as a regular vas reversal, as long as the other side of the tube is long enough to reach.
I hope this helps anyone who is where I was two years ago, desperate for another baby and crying herself to sleep at night because she wants a baby with her husband. GOOD LUCK!