Vasectomy reversal overview
- A vasectomy reversal is a reproductive surgery procedure performed to undo a vasectomy so the man’s sperm can enter the ejaculate stream, making him fertile again.
- Vasectomy reversal is more difficult than a vasectomy because it seeks to connect the tubes that have previously been severed or cinched.
- The chances of success depend on how much time has passed between the vasectomy and the reversal.
What is a vasectomy reversal?
A vasectomy reversal reconnects the tubes that carry sperm from the testicles into the semen. A vasectomy is meant to eliminate the ability to father children, so a reversal restores this capability, and thus restores fertility.
Most vasectomies can be reversed, but this doesn’t guarantee success in conceiving a child. A reversal can be performed several years after the original vasectomy, although the longer it has been, the less likely the reversal will work.
A man can decide to have a vasectomy reversal for many reasons, such as deciding to have another child because he remarried or has an improved life situation.
The reversal surgery requires a small incision on the underside of the scrotum to expose the tube called the vas deferens that carries sperm and releases it from surrounding tissues. Doctors performing this surgery re-attach the vas deferens in one of two ways:
- Vasovasostomy, in which the surgeon sews back together the severed ends of the vas deferens that carry sperm.
- Vasoepididymostomy surgery, which attaches the vas deferens directly to the epididymis, a small organ at the back of each testicle that holds sperm.
Usually the surgeon decides during the operation which technique will work best. A combination of the two can also be done if needed (one on one side, one on the other). After one of the procedures above is performed, the doctor cuts open the vas deferens and examines the fluid inside. If sperm is present in the fluid, the ends of the vas deferens can be connected to re-establish a passageway.
After a successful vasectomy reversal, sperm are again present in the semen, and the man may be able to get his partner pregnant. Studies show that pregnancy rates after a vasectomy reversal range from 40-90 percent. Numerous factors affect whether a reversal is successful, including the amount of time since the vasectomy and the type of vasectomy performed.
Risks of vasectomy reversal
Vasectomy reversal is routinely performed and considered to be a safe procedure. It very rarely leads to serious complications, but risks may include:
- Bleeding in the scrotum can collect and lead to a hematoma that causes painful swelling. Following your doctor’s instructions regarding rest and recovery after surgery can reduce your risks. Your doctor may also tell you what blood-thinning medication you should avoid before and after surgery.
- Infections can occur at the surgery site, which is a risk with any surgery and may be treated with antibiotics.
- Persistent pain is uncommon following vasectomy reversal. See your doctor if you experience this problem.
Benefits of vasectomy reversal
Successful vasectomy reversal restores fertility, enabling a man to have a child. It is a quicker and less expensive treatment than in vitro fertilization (IVF) or an intracytoplasmic sperm injection (ICSI) with surgically retrieved sperm or donated sperm, which would be a woman’s other options to achieve pregnancy if her partner was sterilized by a vasectomy.