A vasectomy is permanent. However, as relationships change and desires for children resurface, men may opt to reverse their vasectomy.
The vasectomy clinic can offer a reversal procedure that reconnects the pathway for sperm to get into semen and restores fertility. It is usually performed in a doctor’s office or surgery center under local anesthesia.
What is a vasectomy?
A vasectomy is a surgical procedure that permanently stops the production of sperm, usually in both testicles. This prevents men from fathering children and can last a lifetime. A reversal can restore fertility, but it is not guaranteed. Many factors can affect pregnancy rates after a reversal, including the time since the vasectomy and the age of the partner. A reversal also doesn’t protect against sexually transmitted diseases, so men should continue to use condoms.
A reversal is done on an outpatient basis with local anesthesia in the scrotum or the sac that holds your testicles. It can be done in 30-60 minutes, depending on the type of reversal and whether or not sperm samples need to be collected.
The urologist makes a small cut on each side of the scrotum. He or she then removes scar tissue and blockages that have formed, leaving two ends of the vas deferens. The urologist checks the fluid from the scrotum for sperm and then sews the ends of the vas deferens together. The urologist may also do a more complicated surgery called a vasoepididymostomy, which connects the end of the vas deferens to the epididymis, a structure on top of the testicles that stores sperm.
After the surgery, your urologist will ask you to wait a few weeks before trying to conceive. Most men can return to work and light activities within a week. They should wear a jockstrap for support for 2 to 3 weeks. They should avoid sex and heavy lifting for a while.
Most men have a good chance of conceiving after having a vasectomy reversal. Pregnancy rates vary depending on how long it has been since the vasectomy was performed, the partner’s age, and the surgeon’s experience. Those with the best chances of getting pregnant are younger and in a relationship with a woman who is a similar age to them. Older men have a much harder time getting pregnant, even with a vasectomy reversal. This is because sperm can die over time and are more likely to be blocked by scar tissue.
How can a vasectomy be reversed?
Men have vasectomies for many reasons. Some want to stop having children, but others find their relationship or partner changes and wish to have a baby again. In about six percent of cases, a man may decide to reverse his vasectomy. During a reversal, surgeons reconnect the pathway for sperm to enter semen, giving couples the ability to conceive naturally.
A vasectomy reversal is an outpatient surgery that typically lasts about three hours. It is performed under local, regional, or general anesthesia. During the procedure, doctors remove any clips or scar tissue that may be blocking the tubes and reconnect them. This can be done by either opening the tube at its original location or joining it to the epididymis. The most common method is called a Vasovasostomy, in which the tubes are rejoined using a technique that allows sperm to flow freely through the penis.
The success rate of a vasectomy reversal depends on several factors, including how long it has been since the initial vasectomy and whether or not the doctor performed a complete or partial reconnection. A simple reconnection is more likely to be successful than a partial reconnection, which involves repairing only a small portion of the vas deferens. Other important factors include the patient’s age and his partner’s age. Men’s sperm production tends to decrease after their mid-30s, and women’s fertility drops dramatically at about age 37.
After the surgery, patients should expect some pain or swelling. Over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs) can help relieve mild pain. In most cases, patients are able to return to work within about a week.
People who are concerned about the possibility of getting pregnant after a vasectomy should talk to their healthcare providers. They can explain all of the options available to them. In addition to a vasectomy reversal, they can also consider sperm aspiration or in vitro fertilization, which are both options that can increase the chances of pregnancy. If a couple wants to try to conceive naturally, they should collect a sample of their semen for testing about six to eight weeks after the reversal. A doctor can analyze the semen for sperm count, sperm motility, and sperm morphology, which helps determine the success rate of the reversal.
What are the success rates for a vasectomy reversal?
When a man has had a vasectomy and wants to father children again, it is often a very emotional decision. It may be because a relationship has ended, or perhaps, he has been diagnosed with cancer, and he now feels the urge to start a family. It is important that men seek a specialist urologist who has completed a fellowship in andrology, the specialty for men’s health, to ensure they receive state-of-the-art care.
Vasectomy reversal surgery has a success rate of up to 90-95 percent. This depends on the type of reversal performed, how long it has been since the vasectomy, and how old his partner is. For example, if it has been a short time and his partner is younger, the chance of pregnancy will be much higher.
Two types of reversal procedures are available. Vasovasostomy is the most common. In this procedure, the urologist re-joins the cut ends of the vas deferens through two small incisions on the scrotum. This is a delicate operation that requires an operating microscope.
A more complicated reversal procedure is vasoepididymostomy. This is performed when part of the epididymis (the coiled mass of tubes in the back of the testicle) has ruptured and created a blockage that prevents sperm from entering the vas deferens. This is a difficult operation and is only used when the patient has no other option.
Both of these procedures are performed under local, regional, or general anesthesia; in most cases, patients do not have to stay overnight. Once the surgery is over, there is some discomfort in the scrotum for a few days, but this can be managed with medication.
After surgery, a man should avoid sexual activity until he has received a semen analysis that shows he is producing sperm again. This will usually take 4 months or less. It is important to follow up with the urologist every few months until there is a positive result.
If a man is not successful in getting pregnant through vasectomy reversal, he should talk to his gynecologist about other ways of achieving a family. It is also important to know that most men keep producing sperm for many years after a vasectomy, even though female fertility declines after age 30.
What are the risks of a vasectomy reversal?
Many people choose to undo a vasectomy for one of two reasons: they have remarried and now want children, or they have lost their partner. In either case, it can be a difficult decision to make, and the men I see at the UCI Health Center for Urological Care are naturally nervous about the procedure and its success rates. The good news is that a vasectomy reversal has high success rates and is safe when performed by an experienced urologist.
The reversal involves joining the cut ends of the vas deferens back together using microsurgery. It may also involve repairing damage to the tube (epididymis) that carries sperm from the testis to the vas deferens. Most people are able to return to work and other activities within a week. I usually recommend ice packs for the first few days to reduce pain and swelling. Over-the-counter pain medications are often effective, too.
While the risk of complications from a reversal is low, it’s important to talk to your urologist about any concerns you have. Some reversals can cause infections at the surgical site, which can be treated with antibiotics. Rarely, a small amount of fluid builds up in the scrotum, which can be painful and may require drainage. Infections can also occur in the tubes that carry sperm from the testis to the ejaculate. Inflammatory reactions can cause these called granuloma and are more likely when there is a long delay between the time of vasectomy and the reversal.
If you decide to have a vasectomy reversal, it’s important to collect a semen sample every four months so that your doctor can assess your sperm count, motility, and morphology. Your chances of becoming pregnant increase if the reversal is done less than 10 years after your original vasectomy. However, even if the reversal is successful, it’s not possible to predict how soon you will get pregnant. This is because women become significantly less fertile starting in their mid-30s, with a sharp drop in fertility around age 37. In addition, older men have a harder time producing sperm due to the effects of back pressure on the testis from the weight of the penis.
