Money-back guarantees
This sounds like a good idea on the surface: if your reversal is not successful, then you get part of the cost of the procedure back as a refund. The reversal doctor offering the guarantee must be incredibly skilled or else he would never make a living, right? Well, not really, as ‘guarantee’ doctors typically own the surgery center or office and therefore keep the facility fee regardless of whether the reversal is successful or not. The most important aspect to consider, however, is how a ‘guarantee’ doctor defines ‘success’ with a reversal. I have heard of ‘guarantee’ doctors defining a ‘successful’ vasectomy reversal as a return of 1 million or more sperm per ml to the ejaculate. This may sound like a lot of sperm until you consider that a normal sperm count is defined as 15-20 million or more sperm per ml. Many patients who have sperm counts of 1 to 5 million per ml still will need to use in-vitro fertilization to establish a pregnancy, which is a route that reversal patients are typically trying to avoid in the first place: not what I would consider to be a very ‘successful’ reversal. This is not to say that all ‘guarantee’ doctors operate in this fashion or that they may not provide excellent surgical results, but it does not necessarily follow that these surgeons must provide superior services or else they would not be in business. The primary question to ask these ‘guarantee’ centers is how vasectomy reversal 'success' is defined, keeping in mind that fertility tends to decrease when sperm counts fall below 15-20 million sperm/ml, and a significant portion of patients with sperm counts less than 5 million/ml may need in-vitro fertilization to have a child (which typically costs at least $10,000-12,000 per cycle).
