Vasovasostomy is a microsurgical procedure to restore fertility after vasectomy, a surgery that sterilizes the patient by severing the vas deferentia, the tubes that carry the sperm from the testes to the penis. After a vasectomy, a patient may have various reasons for wanting to reverse the procedure, such as new opportunities for having children or a new romantic partnership. A vasovasostomy involves reestablishing the flow of sperm through the vas deferens by reconnecting the severed ends of the tube. In 1919, in the United States, William C. Quinby performed the first recorded successful vasovasostomy. Modern improvements on the surgery have led to its adoption as a microsurgery, a procedure that involves a microscope and specialized microscopic instruments. Surgical research over the twentieth century into reconnecting a blocked vas deferens and the resulting microsurgical technique for vasovasostomy has provided a way for people to regain their fertility after a vasectomy.

In 1998, urologists Marc Goldstein, Philip Shihua Li, and Gerald J. Matthews published “Microsurgical Vasovasostomy: The Microdot Technique of Precision Suture Placement,” hereafter “The Microdot Technique,” in The Journal of Urology. The authors describe a novel technique for reversing a vasectomy, which blocks a patient’s flow of sperm, preventing the patient from fertilizing a partner’s egg. The technique relies on the placement of microscopic dots to guide the placement of the stitches that reconnect the vasa deferentia, which is a part of the male reproductive system. The authors, working from the Center for Male Reproduction and Microsurgery at Weill Cornell Medicine in New York City, New York, published the article to instruct surgeons on how to properly employ the surgical technique and provide data to indicate the technique’s effectiveness. Through the publication of “The Microdot Technique,” Goldstein, Li, and Matthews provide guidelines to conduct a more successful and accurate method of a vasovasostomy.

A vasectomy is a surgery that works to inhibit reproduction by interrupting the passage of sperm through the vas deferens, a tube in the male reproductive system. The procedure is a method of inhibiting an individual’s ability to cause pregnancy through sexual intercourse without altering the other functions of the penis and testes. In the US, into the early 1900s, proponents of eugenics, the belief that human populations can be made better by selecting for so-called desirable traits, used the procedure to forcibly sterilize people whom they deemed undesirable. Despite its early associations with eugenics, physicians’ use of vasectomy eventually transitioned into an option for elective contraception. Even with the various shifts in motivation for performing vasectomies, as of 2023, patients have the choice to undergo a sterilization procedure if they want to restrict their own ability to have children.

Vasectomy is one of few widely available methods of contraception for people with male reproductive systems aside from condoms, abstinence, and the withdrawal method, and it is the only one of those options that can be permanent (Amory 2016). The procedure’s prominence has led me to investigate the history of vasectomy and particularly the evolution in vasectomy technique over time. Since its introduction in the late nineteenth century, the procedure has had a variety of impacts on many people across the world. In this research project, I have sought to analyze what the technical evolution of vasectomy reveals about the changing priorities of the medical systems that use it. In particular, I point to ways the eugenics movement’s attempts to control individual reproduction have led to both vasectomy’s efficacy and its restrictiveness.