Having thought about what to say here, I have concerns for you having the hemoclips removed at this point.
I'm not a fan of leaving them in when a reversal for pain is done, but wth do I know. Even top tier pvps docs can't seem to agree on which way is better when doing reversal for pain.
The kicker in your story for me is, you said you started out doing better post reversal.
Having gone through a reversal failure early in my first reversal recovery, I'd tell you it's quite possible that's what's happening to you. Just fyi, I had a second reversal approximately 12 months after my first one. I suppose it's possible something else has went wrong with your healing as well, such as, entrapment/neuroma/leakage/etc, but these are my main thoughts.
You could always prove me wrong, have them removed somehow, and do better. Idk, as this would be a first to my eyes/ears.
I'm pretty smart with this vas stuff, but I honestly don't know if removing the hemoclips is even possible without re-doing your reversal. If it could effect your patency, etc, etc.
Here we go again, but I'd honestly have to recommend the papaya seed powder option instead of TRT. Take it for at least 3~ months. If you have no reason to believe it's helping, I'd consider moving forward with a possible plan B.
Plan C is wait this out indefinitely (12-24+ months) and go from there. Perhaps proceed with plan B again, or even another plan.
In the meantime, and before you start taking papaya seed powder, or TRT, get an SA done asap. That's the first thing you need to address imo.