Vasectomy Reversal: 5 Facts Men Need to Know

Understanding your options for fatherhood
Man and woman laughing in bed

When a man chooses to have a vasectomy, it’s considered permanent sterilization. However, some men will consider vasectomy reversal down the line.

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“Because vasectomies are considered permanent sterilization, a lot of men men don’t realize that reversing it ― for whatever reason life throws their way ― is actually doable,” says Sarah Vij, MD, Director of the Men’s Infertility Service.

Between 6 and 10 percent of vasectomy patients change their minds and undergo a reversal. Life circumstances often spur the decision: a new marriage, a couple simply deciding they want children (or more children), or the death of a child.

Here Dr. Vij explains what men need to know about this increasingly common surgical procedure.

1. Vasectomy reversal: An outpatient operation with high success rates

In a vasectomy, a surgeon clamps or reroutes the vas deferens ― the internal tubing that carries sperm from your testicles and out of the penis. A vasectomy reversal is a minimally invasive procedure that restores continuity.

Surgeons use microsurgery techniques ―using surgical microscopes that can magnify up to 25x and six to eight stitches that are finer than a human hair ― to put your tubing back together. “Surgery takes about two hours,” Dr. Vij says. “You’re able to go home that day.”

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You can go back to work in a day or two, if you have a desk job. Or in three or four days if you have a more strenuous job. And it’s a very safe procedure, with risks of bleeding and infection that are less than half of 1 percent.

2. Your testicles never stopped making sperm

This is a surprise to many men, Dr. Vij says. But after a vasectomy, your testicles continue to produce sperm. It just no longer has a way out of the body.

Because of this, your normal fertility is restored by a reversal. You’ll be asked to abstain from sex for three weeks or so for healing, but then you can start trying to conceive. (In certain cases that involve a blockage in the epididymis (that’s the coiled tube along the testicle where the sperm matures), it may take as long as 12 months for fertility to return.

3. Time is a factor (but not the only one)

There’s a common misconception that if a man had his vasectomy years ago, a reversal won’t succeed. “That’s generally not true,” Dr. Vij says. “Success rates depend primarily on the time since vasectomy.” Success rates can be as high as 95 percent if the vasectomy was done within the last 10 years. They start to decline when a man has had his vasectomy 15 years ago.

There are several factors that will contribute to pregnancy chances even after a successful reversal. The age of the female partner is important as well as the the health of the man’s sperm.

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4. But know it’s not covered by insurance

People who are thinking about undergoing vasectomy reversal may need to pay out of pocket, Dr. Vij notes, given it’s usually not covered by insurance.

5. Fertility is a factor

Men who are interested in a vasectomy reversal ― and their partners ― should be examined beforehand for any fertility issues and to discuss options.

The health of your partner and her fertility also must be taken into consideration, Dr. Vij says.

“In some couples, we opt to do a sperm retrieval procedure to enable in vitro fertilization,” she says. Especially when time is a factor, these methods are a more efficient way to achieve pregnancy than natural methods.

Your doctor can walk you through all of your options to find what is best for you and your family.

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