Realtor Christy Hill met her husband, Bill, six years ago when showing him houses in Hastings. The chemistry was immediate, but so was the arrival of the elephant in their living room. Bill, 39 at the time, was recently divorced with two young-adult sons. And he'd had a vasectomy. Christy, also divorced after a three-year marriage, was 31. Children were "definitely" in her plans. "We both thought the kid issue was a deal-breaker," Christy said.
But neither wanted to break up. "I'm a Christian, so I read a lot in my Bible and I prayed," Christy said. "I decided that a healthy relationship was the most important thing for me. Once I got that into my head, I relaxed and the relationship improved." It improved, in fact, in a miraculous, modern way: They got married and Bill had his vasectomy reversed.
Ethan Hill was born in September 2007. Christy is expecting baby No. 2 in June.
While still rare, vasectomy reversals are growing nationwide, largely the result of medical advances that allow them to be done as outpatient surgery. Depending on how long ago the vasectomy was done, success rates (measured in sperm counts at six- and 12-month intervals) can be as high as 95 percent.
The highest rates are attained within three years of the vasectomy (although one doctor interviewed had success with a man whose vasectomy was performed 24 years earlier). While not cheap, averaging $7,000 to $10,000, a reversal can be far less pricey and invasive than in-vitro fertilization.
Driving the trend, surgeons say, are remarried couples, mostly in their 30s and 40s like the Hills. Many have children from previous marriages but want to have a child or two together. Other times, long-married couples simply have a change of heart and wish to expand their families. Sometimes, the reason is tragic, such as a couple whose child has died.
"By far, the majority [of reversals] are due to remarriage," said Dr. Tony Makhlouf, a urologist and assistant professor of reproductive health at the University of Minnesota. "Very few are much older men, the rich old guy with a younger wife," said Makhlouf, who performs about 30 reversals annually. His success rate is as high as 90 percent at a cost of about $8,000. "Most [spouses] are female professionals who marry later. When I walk into the room and see the couple, I would not know if I was seeing them for a reversal or regular infertility."
While reversal surgery has improved, it's far from easy. Disconnecting a man's "pipeline," more specifically snipping the vas deferens tubes that carry sperm, is infinitely easier than stitching it back together. The surgical thread used is finer than human hair, which is why it's essential to find a skilled microsurgeon with years of practice in reversals. And Makhlouf, like other surgeons interviewed, emphasizes that a vasectomy should not be seen as temporary birth control. "Technically, it is reversible, but we should think of it as permanent. If a childless couple comes to me desiring a vasectomy, I don't do it on their first visit."
Sometimes, he senses that women are pushing partners who really don't want a reversal. Two weeks ago, for example, a patient was cleared for anesthesia, had paid his money and, at the last minute, canceled. "The relationship had just broken up," he said. "But it is not my decision to make reproductive choices for couples. I'm there to help them achieve whatever choice they want."
'Life throws you a lot of curves'
Jennifer and Rob Dusek, who live near Chicago and have been married 14 years, always wanted a big family and they got one: Cora, now 11; Christian, 9, and Taylor, 8. But life took a chilling turn when Taylor was born with a nearly fatal medical condition. Her parents, panicked that the condition might be genetic (although it wasn't) decided on a vasectomy two months after her birth. "We were so afraid to tempt fate," says Jennifer, 36, a homemaker.
Taylor underwent two surgeries and began to thrive. Jennifer tried to ignore her reignited baby lust. Rob, 41, was sure it would go away. It didn't. After five years, they began to price reversals and decided to go for it. They found a doctor through a neighbor who had had a successful reversal. Plus, this doctor only charged $2,000. The surgery was a disaster. Rob suffered "horrible" pain and swelling. Worst of all, after a full year, his sperm count was still zero.
"There were times when we said, 'Let's just be done,'" Jennifer said. But she couldn't let it go. She started researching on the Web and found Dr. Douglas Schow, 46, founder of the Minnesota Men's Health Center in Woodbury. Schow says that 95 percent of his business is reversals, 200 to 250 annually. He claims a 97 percent success rate among men whose vasectomies were done within the previous 12 years and even offers a refund to couples if sperm are not restored.
The Duseks decided that this would be their last chance. They made an appointment, then got cold feet and canceled. "I felt physically sick to my stomach," Jennifer said. "What if we didn't get a baby? We'd already paid $2,000, and now it would be another $7,000."
They immediately called back and rescheduled, put their kids in the car and drove the 350 miles to Schow's clinic on Dec. 15, 2007. "We were very upfront with the kids because they needed to know why Daddy was on the couch and they couldn't go near him," Jennifer said. Two months later, they were pregnant. Jack was born on Nov. 16, Jennifer's birthday. "People thought that we were nuts," Jennifer said. "But the bigger kids love him, love him, love him."
Rob is candid about the procedure. "I tell guys that it's twice the pain of the original vasectomy, and twice the time to recover." Still, he has no regrets. "Life throws you a lot of curves," Rob said. "You really should think before you have a vasectomy. You shouldn't make an emotional decision like we did." They're thinking about one more baby, but are tabling that discussion for now.
The Hills, on the other hand, know they'll be done after baby No. 2 arrives in June. "I'm getting fixed," Christy said with a laugh. "Bill's done it twice."
Gail Rosenblum • 612-673-7350
