Considering Vasectomy Reversal? What to Know First
Every year, an estimated 500,000 U.S. men seek permanent birth control through a vasectomy, or sterilization. And each year, an estimated 30,000 of those men want to have their vasectomies reversed.
If you are among the 6% who want to pursue fatherhood again, there is a procedure that might make that possible. It’s called a vasectomy reversal, and you should know several factors will determine its success.
Learn more about fertility specialist, Dr. Mahdi Bazzi.
There is much to consider before choosing a vasectomy reversal. To help you prepare for a consultation, here is an overview:
How a Vasectomy and Vasectomy Reversal Work
A vasectomy is a relatively quick procedure during which the surgeon cuts and then seals the two slim tubes your sperm use (the vas deferens) to reach the penis from your testes. You still make sperm, but with their normal passageway blocked, the sperm just enter your body and are absorbed. Further, your libido remains intact, and your prostate continues to make fluid, so you retain all the working parts to make semen. Find more details about what to expect from a vasectomy here.
A vasectomy reversal requires a more complex surgery, of which there are two approaches. Each is performed by a microsurgeon who must first examine your vas deferens for the presence of sperm before determining which approach to take, in real time in the operating room. These approaches are:
- A vasovasostomy. If sperm is found in the fluid extracted from the vas deferens, you’ll undergo this approach to reconnect and open the tubes. The surgeon will make one or two tiny incisions in the scrotum, then use an operative microscope to find and reconnect the vas deferens with microsutures. Expect to be anesthetized (asleep) through the outpatient procedure, which can take several hours.
- An epididymovasostomy is more complex. If the microsurgeon cannot find sperm during the examination, then a blockage might have formed within the tightly coiled tube behind the testes, where sperm mature. This tube is called the epididymis. In this case, your surgeon will need to attach your vas deferens directly to the epididymis to bypass the obstruction.
Read more about vasectomy reversals and candidate evaluations here.
Important Facts to Consider Before a Vasectomy Reversal
While a vasectomy reversal is typically performed on an outpatient basis, do not underestimate the seriousness of the procedure. All surgeries require careful thought, and your doctor will not take this procedure lightly. Here is what you should expect.
You and your partner will undergo an evaluation. Just as your doctor screened you before undergoing a vasectomy, your vasectomy reversal surgeon will screen both you and your partner to evaluate your reproductive health and ability to get pregnant. A blood test might be ordered to measure hormone levels and testicle function.
Time and anatomy can determine your success rate. The chance of successfully restoring male fertility is greatest if performed within three to 10 years after the vasectomy. Beyond that, success rates taper off. Overall, pregnancy rates can range from nearly 30% to as high as 90%, depending on the procedure you undergo and the time lapse since the vasectomy.
Check with your insurance about coverage. A vasectomy reversal, because it is more complex, can cost much more than a vasectomy, and most insurance policies do not cover the procedure.
Recovery can take longer than that of a vasectomy. Typically, you should be up to performing normal activities, including sex and light exercise, within three weeks of the reversal. Prepare for mild to moderate groin pain and swollen, achy testicles for about a week. Ice packs should alleviate the sting, as well as dedicated rest. Your doctor will provide instructions on caring for the incision to avoid infection. You might be ordered to limit strenuous exercise, lifting, and other activities for up to eight weeks to avoid testicular torsion (twisting).
Producing viable sperm can take months. Your doctor will perform a semen analysis for sperm two to three months after the vasectomy reversal. In the lion’s share of patients, sperm will return to the ejaculate in this time, about three months. Yet in some cases it can take much longer: up to six to 12 months after a vasovasostomy, according to Johns Hopkins Medicine, and up to 18 months after an epididymovasostomy. Factor the time lapse into your family-building plans.
There are alternatives to a vasectomy reversal. If you opt against a vasectomy reversal, you can consider in vitro fertilization (IVF). In this procedure, your sperm is harvested and combined with a female’s eggs in a lab (some men preserve their sperm in a sperm bank before a vasectomy). The sperm and egg form an embryo, which is placed in the woman’s uterus using a syringe. Your female partner will need to take fertility medications, and the process can be time-consuming.
A Vasectomy Reversal Should Not Be a ‘Plan B’
If you are thinking about getting a vasectomy, do not do so with a reversal in mind. A vasectomy reversal is not guaranteed to make you fertile again. Further, all surgeries – even outpatient procedures – can involve complications and should be carefully considered.
However, a vasectomy reversal offers real hope if your life’s passage leads you back to wanting a child. Choose a specialist who has performed the procedure many times and therefore has advanced training, experience, and precision, as well as state-of-the-art magnification equipment, to improve your chances of success.
Bring a list of questions to your consultation to address these factors. They will help your doctor screen you thoroughly to ensure you are a good candidate.
Still curious about a vasectomy reversal? You can review common questions and request a consultation on our website, “Vasectomy Reversal and Infertility.”
Share This Post
