More than 50 million men in the US have had a vasectomy, and more than 500,000 more elect to receive one each year. Although they're an extremely effective option for contraception, most people believe they're permanent solutions that can't be undone. But can you reverse a vasectomy? And if so, can it result in pregnancy? Here, we'll answer all your questions about vasectomy reversal, its safety, and its success.
What is a Vasectomy?
A vasectomy is a minor surgical procedure used for male contraception. It involves cutting and sealing the vas deferens, the tubes that carry sperm from the testicles to the urethra. This prevents sperm from mixing with the semen that is ejaculated during orgasm, thus preventing fertilization. However, men will still be able to ejaculate—it just won't contain sperm.
The procedure is typically done under local anesthesia and is considered safe, with a low risk of complications. Recovery time is short, and it has no significant long-term effects on sexual function.
Before getting a vasectomy, it's important to speak with your female partner about their family goals and ask your doctor as many questions as you have. Although fertility may be restored in a reversal surgery, it's not guaranteed. Utilizing fertility preservation options like sperm banking can make it possible for future pregnancies through in vitro fertilization.
What is a Vasectomy Reversal?
A vasectomy reversal is a surgery that's done to essentially reconnect the two cut ends of the vas deferens and allow sperm to reenter seminal fluid for fertility reasons. There are two ways vasectomy reversals are performed, but both are considered technically challenging procedures.
How Are Vasectomy Reversals Performed?
A vasectomy reversal may be a bit more complicated than your original surgery, but it's still considered an outpatient procedure, so you can go home the same day. Some doctors will use general anesthesia, while others prefer local anesthesia. Your surgeon will discuss your options beforehand so you know what to expect and how to prepare.
Since reversals are more complicated, the procedure may require microsurgery for fewer risks. This will magnify the vas deferens so it can be reconnected with more precision. There are two different ways that a vas deferens will be reattached at the vasectomy site, which include the following.
- Vasovasostomy — This type of microsurgical vasectomy reversal will require the surgeon to sew the two ends of the vas deferens back together so sperm can reenter semen and be used for fertilization.
- Vasoepididymostomy — This surgery takes the vas deferens and reattaches it directly to the epididymis, which is the small organ at the back of each testicle that holds sperm. Although it's more complicated, it may be more successful in certain individuals and is performed when a vasovasostomy isn't possible.
Why Would Someone Want a Vasectomy Reversal?
About 6% of men change their minds after a previous vasectomy. This may be because they changed partners and started a new relationship, decided to grow their family with their current partner, or simply wanted to restore fertility. Some men may also get a reversal if their vasectomy causes pain in the testicles. It's a personal choice and can be made regardless of when they underwent the original surgery. In fact, successful reversals have been done more than 30 years after the original vasectomy procedure.
However, while vasectomies can be reversed, the process is a bit more complicated than the original and may not be covered by insurance.
Pregnancy Rates After Vasectomy Reversal
Vasectomy reversal has a variable success rate, with sperm entering semen between 60% and 95% of the time. Pregnancy is possible more than 50% of the time after a reversal surgery is performed. Of course, your partner's fertility will also make a difference in whether you can successfully conceive. Certain additional factors affect whether you'll be on a higher success rate or lower.
The longer the gap between the time of the reversal and the time since your vasectomy, the lower your success rate may be. Generally speaking, success rates begin to decline about 15 years after the original procedure.
Success rates may decrease if an individual gets a vasoepididymostomy instead of a vasovasostomy. This is due to the nature of the procedure, so it's important to talk to your doctor to understand your circumstances better.
To increase the success rate of your reversal, it's important to work with a specialist who has performed the procedure several times. The procedure will need to be guided under a microscope and requires extreme precision, so finding a qualified surgeon who can perform a successful vasectomy reversal is essential.
Risks of Vasectomy Reversal Surgery
One of the biggest risks when getting a vasectomy reversal performed is the lack of success with conception. Although technically, a reversal can be done even if many years have passed since the initial vasectomy, the longer you wait, the less likely it will be successful. Some other potential risk factors include the following:
- Infection — A vasectomy reversal surgery is quite straightforward, but any type of surgery carries a small risk of infection. Your doctor will tell you how to care for your incision post-op to minimize the risk of complications.
- Bleeding in the Scrotum — Hematoma is a collection of blood that can result in uncomfortable or even painful swelling. After reversing your original vasectomy, this can happen in the scrotum. Your risk can be minimized by following your doctor's post-op treatment plan and applying ice packs as necessary.
- Pain — Although rare, some individuals may experience chronic pain following a vasectomy reversal surgery.
If you experience any signs of an infection, bleeding, or pain after your surgery, contact your doctor immediately.
How to Prepare for a Vasectomy Reversal
Although a challenging procedure, vasectomy reversals are generally quite straightforward for the recipient. Your doctor may ask you to shave the area before your surgery, either the evening prior or the morning of. A single-blade disposable razor should be used to reduce irritation and lower the risk of cuts. You'll also want to thoroughly wash the area and follow food and drink regulations based on the type of anesthesia you'll get.
Vasectomy Reversal Recovery Tips
Recovering from a reversal surgery will be similar to the recovery from a vasectomy. You'll need to take a few days off to rest, usually about 48 to 72 hours if possible. During this time, try to stay off your feet and just relax. You can keep your feet elevated and move around a little, but the more you rest, the faster you'll recover from a vasectomy. Keeping the incision site clean and dry is also important to reduce your risk of infection. Your doctor will give you specific instructions for cleaning and care.
Feeling discomfort at the incision site is normal, but ice packs should help. Your doctor may also have you go home in an athletic supporter to help minimize swelling. Any stitches that are present should dissolve within seven to 10 days.
Following vasectomy reversal, it's important to limit strenuous activities that could result in testicular torsion or other injuries for about six to eight weeks. You will also need to wait two to three weeks (pending your doctor's clearance) following surgery to ejaculate.
About six weeks after the time of reversal, your doctor will have you undergo a semen analysis. This is to determine if sperm is present in the semen. This can be a bit nerve-racking for some, but it's important to be patient as everyone is different. Some men find that sperm returns weeks after a vasectomy reversal, while it takes months for others. Usually, if a vasectomy reversal is successful, sperm will return within one year.
Should You Undergo a Vasectomy Reversal?
A vasectomy is a common procedure and one of the safest options in terms of birth control available. Still, if you change your mind, you may worry about your partner's ability to get pregnant later. You should take the necessary precautions before undergoing the initial surgery, but if a vasectomy was done in the past and you want a reversal, it is possible. Talk to your doctor to learn more or if you have any additional questions.
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