Your original decision to have a vasectomy was probably based on a clear understanding that it was to be a permanent procedure. Hopefully, you considered all of your options and decided that having a vasectomy was the proper course for you and your spouse at that time in your life.

And, when you decided on the procedure, you were aware that a vasectomy is highly effective, in part, because it is meant to be lasting.

When Life Takes a Turn

Circumstances change. Life and living situations can shift significantly. As a result, each year, a growing number of the men who have had a vasectomy are opting for a reversal. While about 500,000 men undergo a vasectomy annually in the United States, many will consider having a vasovasectomy in order to reverse the procedure and allow them to father a child.

Remarriage is perhaps the most common reason that 50,000 or more men have a vasectomy reversal each year.

You'll want to gather all the information you can. Then make an appointment with a reversal surgeon to discuss the vasectomy reversal risks, latest techniques and reversal procedures available.

Can a Vasectomy Reversal Be Successful?

The answer is generally 'yes,' but some people make better candidates than others. Using the latest vasectomy reversal techniques, rejoining the cut ends of the vas deferens is technically possible, but it is a significantly greater challenge than the vasectomy. Advances in microscopic surgery have made this extremely delicate surgery more common and more available than in the past; however, this does not mean that a vasectomy should be looked upon as a temporary option. During a vasectomy, the vas deferens are cut, and a portion of the vas may have been removed, so that these two tiny tubes no longer transport sperm from the testicles and epididymis to the penis during sex. By interrupting the flow of sperm, men become sterile, although ejaculations and sexual climax are otherwise exactly the same.

An Experienced Vasectomy Reversal Surgeon

A key factor to your vasectomy reversal success rate will be the skill and experience of the vasectomy reversal surgeon.
Disconnecting this miniature pipeline (the vas) is easier, obviously, than stitching it back together again. The vas itself is only about the diameter of a round shoelace. The inner channel of the vas, which reverse vasectomy doctors must align, is only about one third of a millimeter in diameter. The surgical thread (suture material) that a vasectomy reversal surgeon needs to knit the two ends together is finer than a human hair, and nearly invisible. This microsurgery is usually done under a powerful microscope.

The skilled work of the surgeon has to reconnect the previously cut ends of the vas deferens accurately in order to rebuild an open vas channel. In some cases, if part of the vas or epididymis is damaged, the surgeon must connect the vas end to the epididymis even further upstream from the damage. This more complicated procedure is called a vasoepididymostomy.

Statistical Success Factors

As you can see the vasectomy reversal success rate depends on many factors. Success depends on the microsurgical skill of the vasectomy reversal surgeon and the condition of the patient's tissue after the original vasectomy. Assuming an experienced surgeon, there are clues before and during the surgery, which help predict the condition of the tissues and thereby help predict the chances of success.

A key question, according to most reverse vasectomy doctors, is how long ago the vasectomy was performed. In general, men who have had their vasectomy less than 10 years ago can expect a better vasectomy reversal success rate. If the original procedure was performed less than three years ago, the statistical probably of reopening the vas channel is as high as 97 percent. However, if 15 years or more have passed, the chances drop to 71 percent (See chart below.)

While these percentages seem good, the passage of time also reduces the chance of a pregnancy, even when sperm are able to cross the repaired area of the vas.. Even with current vasectomy reversal techniques resulting in higher success rates, as sperm quality diminishes over time, so will the likelihood of pregnancy after a vasectomy reversal. The new sperm may no longer be able to complete the process of fertilization. The following table is based on a study of over 1,000 patients by multiple vasectomy reversal surgeons*.

Vasectomy Reversal Success Rate
Years since vasectomy	Chance of rebuilding an Open Vas Channel	Chance of Pregnancy After Vasectomy Reversal
Less than 3 years	97 %	76 %
3 to 8 years	88 %	53 %
9 to 14 years	79 %	44 %
Greater than 15 years	71 %	30 %

* Belker AM, et al. Results of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group. Journal of Urology 1991; 145(3):505-11.



Vasectomy Reversal Success Clues during surgery.

There are important predictors of your vasectomy reversal success rate that occur during surgery. During the procedure, the vasectomy reversal surgeon can examine the quality of the fluid coming from the vas end at the vasectomy site. Reverse vasectomy doctors know that when they find fluid with sperm cells coming from the vas, in more than 90 percent of patients they can reconnect the vas ends and re-establish an open channel. (See the Belker Study data).

However, if only fluid without sperm can be seen coming from the vas end, the surgeon can build an open channel through the vasectomy site in somewhat greater than 50 percent of patients. The actual pregnancy rate after vasectomy reversal is this case would be closer to 40 percent.

If the fluid is poor and sperm are absent, the vas can be directly connected to the epididymis (epididymovasostomy), but there is a further reduction in the potential vasectomy reversal success rate.

Every case is unique.

Because a vasectomy is intended to be a permanent change, there are no guarantees about the success of a reversal. The chances of success can range from good to excellent.

What factors will impact your vasectomy reversal success rate? Talk over the possibilities with a qualified doctor so you can make an informed decision.

In Summary:

• A vasectomy is intended to be a permanent procedure.
• Due to life changes, like remarriage, more than 50,000 men have their vasectomies reversed each year.
• As vasectomy reversal techniques improve and develop, reversals are becoming more common and available.
• Reconnecting the cut ends of the vas deferens is delicate microsurgery and your vasectomy reversal success rate depends on many factors.
• Success factors include having a skilled vasectomy reversal surgeon, the condition of tissue and the time that has passed since the original vasectomy.
• Reverse vasectomy doctors conducted a major study which found that successful rebuilding of the vas open channel with passage of live sperm ranged from 71 percent to 97 percent, depending on the years since vasectomy.
• The same study found the chance of pregnancy after vasectomy reversal ranged from 30 percent to 76 percent. (See chart above.)Vasectomy reversal risks and your personal success factors should all be discussed with your doctor.