If you and your partner are looking into the possibility of a vasectomy reversal, you probably have questions. Take some time to review our answers to the most commonly asked questions about this surgical procedure. You can also obtain more in-depth information on this website, and always discuss your questions and concerns with your doctor.
What is a vasectomy reversal?
During a vasectomy, the vas deferens tubes that carry sperm from the testicle to the ejaculate are cut, making the man sterile. Vasectomy reversals are microsurgical procedures performed by urologists that aim to restore a man's fertility and help a couple conceive naturally.
There are two main techniques for reversing a vasectomy, depending upon which tubes are connected to allow sperm to once again enter in the semen:
- A vasovasostomy, in which the cuts ends of vas deferens are reconnected
- A vasoepididymostomy (also called an epididymovasostomy), in which the vas deferens is connected to the epididymis, the tube on the back of the testicle where the sperm mature
You may not know beforehand which technique will be used for your vasectomy reversal. The surgeon must decide how to proceed during the surgery itself, depending on whether the vas tubes are clear or whether there appears to be a blockage.
How effective is the procedure and what influences success?
Fertility is not immediately restored after surgery. It can take several months, and in some cases more than a year, before a reversal can be counted as successful.
The effectiveness of a vasectomy reversal is measured by the presence of sperm in the semen (or patency), as well as the occurrence of pregnancy after the procedure. Overall, sperm returns to the semen in about 92 percent of vasectomy reversals; 30 to 60 percent of them result in natural pregnancies. One of the more common reason for such a discrepancy is the presence of anti-sperm antibodies, which can attack sperm and impair their motility. In these cases, sperm washing combined with artificial insemination can be successful.
Several factors affect the success of a vasectomy reversal:
- Surgical technique used (see below)
- Use of a surgical microscope
- Time since original vasectomy
- The age and health of a man's partner
Which techniques have better success rates?
The surgeon will choose the vasectomy reversal technique that best fits your situation. Sometimes, they may even do a vasovasostomy on one side and an vasoepididymostomy on the other.
According to vasectomy reversal statistics, the vasovasostomy offers greater success rates than does the more complex vasoepididymostomy.
The vasovasostomy is a simpler procedure that, when used appropriately, tends to have higher success rates, with patency and pregnancy rates of 79 percent and 40 percent respectively (in men who were 10 to 24 years post-vasectomy).
With recent advances in surgery techniques, however, vasoepididymostomy has similar success rates--67 percent patency and 33 percent pregnancy rates (in those men who had a reversal 10 to 24 years after their original vasectomy).
How long will it take to get pregnant?
On average, it takes about a year for a woman to get pregnant after her partner has a vasectomy reversal. (For more information, see How soon until a vasectomy reversal results in pregnancy?) Some pregnancies may occur within a few months, while others may take up to a few years.
How much time should I allow for the procedure and recovery?
Vasectomy reversals are time-intensive and complex. The vasovasostomy procedure can take anywhere from 2.5 to 4 hours while a vasoepididymostomy, when needed, can lengthen surgery by another couple of hours. Both procedures require the use of general anesthesia, which typically adds time to the initial recovery period.
Long-term recovery after a reversal, however, is relatively quick. You will be able to resume your normal routine after about a week, although you should avoid heavy physical activity for two to three weeks.
How soon until I can start having sex again?
Most doctors advise waiting two weeks before resuming sexual activity, although different surgeons may have slightly different recommendations. Once you've sufficiently recovered, your sex drive and your ability to have an erection and orgasm should be the same as it was before the surgery.
Does a vasectomy reversal leave scars?
Although the incision site for a reversal may be larger than for a vasectomy, the scar will be small and difficult to detect on an unshaven scrotum.
A no-scalpel vasectomy reversal will leave an even smaller scar, less than one centimeter long. But this type of procedure has its drawbacks, including the fact that it can only be used for a vasovasostomy.
Are there risks or side effects?
While microsurgical vasectomy reversal techniques are complex and delicate procedures, they do not pose high risks for serious complications. The most common risks include:
- Swelling inside the scrotum, caused either by bleeding or a buildup of fluid
- Chronic pain
- Infection at the site of surgery
- Inflammation caused by leaking of sperm into the scrotum
See Vasectomy Reversal Risks, Side Effects, and Complications for more information.
How much does the procedure cost?
A vasectomy reversal can cost anywhere between $5,000 and $15,000 (see How much does a vasectomy reversal cost?). Among other things, costs can vary depending on your geographic area, the urologist you choose, and which procedure the surgeon performs. When discussing cost, be sure to ask the office staff whether the fee is all-inclusive, or whether the procedure time, operating-room and anesthesia fees as assessed separately.
Is vasectomy reversal covered by insurance?
Vasectomy reversals are generally not covered by insurance. You should, however, check with your insurance company about coverage before deciding between reversal and other fertilization options, such as the (often) more expensive in vitro fertilization.
Reviewed November 19, 2012 by Sarah K. Girardi, MD - Urologist
van Dongen J., Tekle F.B., & van Roijen J.H. Pregnancy rate after vasectomy reversal in a contemporary series: influence of smoking, semen quality and post-surgical use of assisted reproductive techniques. BJU Int. 2012;110(4):562-7.
Michielsen D., & Beerthuizen R. State-of-the-art of non-hormonal methods of contraception: VI. Male sterilisation. Eur J Contracept Reprod Health Care. 2010 Apr;15(2):136-49.
Comparison of Vasectomy Reversal and Intracytoplasmic Sperm Injection. Fertility Weekly. (2003). p12