Vasectomy Reversal

Vasectomy reversal at a glance

  • A vasectomy ties or severs the tubes in a man’s testicles that carry the sperm to the semen for ejaculation (which are called the vas deferens).
  • To reverse this procedure, the tubes must be reconnected to reopen the sperm’s passage to the semen.
  • A vasectomy reversal usually is effective in restoring a man’s fertility.
  • Sometimes a sperm blockage exists that wasn’t detected during surgery or that developed afterwards, causing the procedure to be unsuccessful.

About vasectomy reversal surgery

There are several reasons a man may choose to have a vasectomy reversal, such as remarriage, improved finances that make starting a family easier, or loss of a child. In more rare circumstances, a man may have testicular pain caused by a vasectomy, and will choose to have a vasectomy reversal as treatment. Reversing a vasectomy is easier within several years of the original procedure. However, the more time between a vasectomy and the reversal, the harder it is to achieve a successful result.

A urologist usually performs a vasectomy reversal at a surgery center or hospital using anesthesia. It is generally an outpatient procedure (the patient does not require an overnight stay). The patient should consult with the urologist or surgeon beforehand to discuss the potential risks and complications, as well as how to prepare for pre and post surgery.

There are two ways to reverse a vasectomy:

  • Vasovasostomy, a procedure that sews the severed ends of each tube back together.
  • Vasoepididymostomy, a more complicated surgery that attaches each tube directly to the coiled tube at the back of the corresponding testicle. This procedure is generally chosen only when a vasovasostomy will likely be unsuccessful or cannot be performed, which is generally decided during the operation.
  • Sometimes a combination of both surgical procedures is needed – vasovasostomy for one side and vasoepididymostomy for the other.

Six weeks after surgery, the urologist will use a microscope to examine the patient’s semen for the presence of sperm. If the reversal is successful, sperm usually appear in the semen within a few months. However, normal sperm production and release may take up to a year or more. Within two years after a vasectomy reversal, about half of men are able to achieve pregnancy with their partners.

When a vasectomy reversal is unsuccessful

Sometimes a sperm blockage exists that wasn’t detected during surgery or that developed afterwards, causing the procedure to be unsuccessful. In this case, a man may choose to undergo a second vasectomy reversal. If success cannot be achieved, fathering children is still possible through one of several techniques that can retrieve the man’s sperm for use during in vitro fertilization (IVF).

Before the procedure, the patient can also arrange for the surgeon to remove any sperm found during surgery for cryopreservation (sperm freezing) in case the vasectomy reversal does not work. Cryopreserved sperm can be thawed and used in an IVF procedure.