Each year, more than half a million men in the United States have vasectomies as a method of birth control. In a vasectomy, doctors disconnect the small tube that carries sperm to mix with semen. The sperm is absorbed into the body before ejaculation, preventing pregnancy. It’s more than 99% effective, but what happens if you change your mind and decide you want a child?
Vasectomies are almost always reversible with an outpatient procedure. Success rates, as measured by pregnancy following a reversal, range from 30 to 90% depending on several factors. Here’s what to know about vasectomy reversal.
In a vasectomy reversal, your doctor will reattach the vas deferens tube that carries sperm so it can mix with semen during ejaculation. The procedure is usually simple, but there are considerations that affect the chances of conceiving after a reversal:
Time: The shorter the time between vasectomy and reversal, the more likely it is that sperm will return to the semen. However, you can still have a successful reversal years after a vasectomy.
Choice of surgeon: A surgeon who does the procedure on a regular basis increases your chances of a successful reversal. Experience and training count because they contribute to the surgeon’s ability to deal with individual differences in anatomy.
Prior fertility issues: If you had a low sperm count or other factors that made you less fertile before your vasectomy, you are likely to have them again. You can discuss infertility treatment or alternative types of conception if no pregnancy results after a reversal.
Quality of fluid in the vas deferens: If there are mobile sperm in the vas deferens when the reversal is done, the success rate will be 100% in restoring fertility, though it does not guarantee pregnancy.
It may take anywhere from a few months to a year or more for your partner to get pregnant after a vasectomy reversal. Your doctor can test your semen periodically to see if sperm have returned after the reversal. If there is no pregnancy, it may be due to factors other than the reversal.
Vasectomy reversals are performed as outpatient surgery and can be done under either local or general anesthesia. The procedure usually takes 2 to 4 hours, using a microscope and sutures finer than a human hair. There are two basic approaches to vasectomy reversals:
Vasovasostomy: A vasovasostomy is the more common vasectomy reversal procedure. The surgeon reattaches the two ends of the vas deferens that were cut during the original procedure.
Vasoepididymostomy: Surgeons use this more complex approach if there is scar tissue blocking the vas deferens. Instead of connecting the two ends, the surgeon stitches the vas deferens to the epididymis, a duct behind the testes where the body stores sperm. Before your surgery, you should ask your surgeon if they will be able to do this procedure if needed.
Vasectomy reversal is a low-risk procedure with less than a 1% complication rate. You can expect to go home the same day and return to office work in a couple of days. You may have to wait a few more days if your job requires physical activity. You should be able to have sex about two weeks after the procedure, but make sure you follow all your doctor’s post-operative instructions.
Tests to check your sperm count are important after a vasectomy reversal. Sperm can appear in the semen a few months after vasovasostomy but it may take longer after a vasoepididymostomy. You should remain fertile after the reversal.
Vasectomy reversals are not generally covered by insurance. The cost ranges widely, depending on your location. The quality of care and doctor’s expertise will affect your chances of a successful reversal, so choosing the right surgeon is an important component of a successful vasectomy reversal.
