The Reversal of a Vasectomy: How It’s Doable

December 22, 2020

Couples typically come to the conclusion that it is “time” for a vasectomy when they have agreed that they no longer wish to conceive due to a multitude of reasons (age, finances, health risks, an aversion to further diaper changing) and prefer a more permanent method of contraception than birth control pills, patches, condoms. But what happens if minds change after a vasectomy? Is that vasectomy reversible?

Vasectomies are a common procedure with about 500,000 vasectomies performed in the US each year. A vasectomy is an easy and practical approach to a contraceptive method that has a 0.15% failure rate.

A vasectomy is typically done in office in about 20 minutes by a urologist. There is very little need to prep, minimal recovery time and very few risks. The procedure is considered successful when sperm are no longer able to leave the testicles. Without sperm, conception is not possible. Mission accomplished!

During a vasectomy, the vas deferens (a thick-walled tube that transports sperm cells from the epididymis, where the sperm are stored prior to ejaculation) is closed off typically by removing a segment, tying off and heat sealing the ends. All of this provides three levels of protection from sperm getting from one side of the vas deferens to the other. Essentially, a vasectomy permanently closes the “hallway” (vas deferens) for sperm to make their way out of the body.

A vasectomy reversal is surgery to undo a vasectomy. It reconnects each tube (vas deferens) that carries sperm from the testicles into the semen (ejaculate) and out of the body.. After a successful vasectomy reversal, sperm are again present in the semen and pregnancy is possible.

Vasectomy reversals, on the other hand, are performed in a surgery center under anesthesia. The procedure can take anywhere from two to four days. Recovery takes about two weeks.

The success rate in a vasectomy reversal resulting in pregnancy can vary greatly from about 30 to 90 percent depending on the procedure and if there are any other factors for either partner that may contribute to difficulty or inability to conceive. The chances of a successful reversal may be lower if it’s been over 10 years since the vasectomy. A vasectomy can be reversed using one of two methods:

Vasovasostomy: The ends of the vas deferens from the testes to the penis are sewn back together.

Vasoepididymostomy: The vas deferens is reattached to the small organ at the back of each testicle that holds sperm. The success of a vasectomy reversal surgery will depend on many things, including the type of surgery you originally had.
A vasectomy reversal is successful if sperm appears in the semen after a few months. It can take a couple of turnovers of sperm reserve before sperm count returns to a level where getting pregnant is optimal. Samples of ejaculate will be collected and examined for four to six months, which is about the time for the sperm counts to stabilize. It can take anywhere from six months to one year before sperm to return with a vasovasostomy. If a vasoepididymostomy is performed to reverse the vasectomy, it may take longer than one year for sperm to appear in the semen. However, once sperm comes back the chances to conceive goes up.