Overview

Are Vasectomies Reversible?

Are Vasectomies Reversible?

Although vasectomy should be considered an irreversible procedure, this technically isn’t true. Changes in your life or relationships may cause you to want to have a child. If you’ve had a vasectomy in the past, surgeons may be able to reconnect your vas deferens tubes by bypassing scar tissue around these tubes.

There are various techniques for a vasectomy reversal. Your surgeon will discuss the differences between each technique. Vasectomy reversals are done using general anesthesia. You also won’t need to say in the hospital overnight to recover.

Vasectomy Reversal Cost

Typically, insurance doesn’t cover vasectomy reversal. The cost will depend on where you live, but usually costs $8,000 in total, including consultation, surgery, and anesthesia.

Vasectomy Reversal vs. IVF

Some men will wonder whether they should have a vasectomy reversal or IVF. Vasectomy reversal has a few advantages over IVF. These include the following:

  • Vasectomy reversals are much less expensive than in vitro fertilization (IVF) or most other reproductive technologies.
  • It’s possible for you and your partner to have multiple pregnancies after a vasectomy reversal. But with IVF or other reproductive technologies, you will only have one pregnancy. Each cycle is designed to result in only one pregnancy and birth.

Find a Fertility Specialist

Please enter a valid zip code or city, state.

Vasectomy Reversal Procedures

Surgeons generally use two procedures to reverse a vasectomy:

  • Vasovasostomy
  • Epididymovasostomy

Vasovasostomy

Vasovasostomy is the most common technique for vasectomy reversal. During this three-hour procedure, your surgeon will sew the cut ends of the vas deferens tubes back together using a high power surgical operating microscope and sutures (stitches). These stitches are finer than a human hair and are so small that the naked eye can’t see them very well.

We use an operating microscope that magnifies 30-40 times. We want to make sure your tissue is handled extremely carefully. We perform both one- and two-layered anastomoses. Both of these techniques reconnect vas deferens tubes that were previously severed during a vasectomy. Current studies don’t show that one technique is better than the other.

To reverse your vasectomy, your surgeon will perform several steps. Your surgeon will:

  1. dissect your vas deferens tubes,
  2. identify where your tube is blocked from the vasectomy,
  3. cut the vas deferens above and below this blockage,
  4. and then place six to ten very fine stitches to reconstruct your tube.

Before placing any stitches, your surgeon will examine the fluid coming from the testicular end of your vas deferens tubes under a microscope. We will only perform a vasectomy reversal if fluid is still present in your vas deferens at the time of surgery. If you don’t have any fluid, we will perform an epididymovasostomy.

Epididymovasostomy

Epididymovasostomy is a more complex version of the vasovasostomy. Surgeons will choose this procedure if your sperm is getting blocked in your epididymis. This procedure is one of the most complex microsurgical procedures performed. We typically use the intussusception technique.

This technique involves placing two or three 10-0 sutures in the distended epididymal tubule and then connecting them to the vas deferens before opening the tubule. This makes the procedure much easier because your surgeon can place the sutures in the enlarged distended tubule rather than the open deflated tubule.

Once your surgeon places all the sutures, your surgeon will open the tubule with a microsurgical knife and then tie the sutures down.

Vasectomy Reversal Success Rates

Vasectomy reversal surgeries are usually successful in the hands of fellowship-trained microsurgeons who regularly perform them. But the surgery does have some risks.

Some men have no sperm or few sperm, even if their vas deferens tubes are successfully reconnected. Scarring, chronic congestion, or developing anti-sperm antibodies can cause men to have few or no sperm. If your vasectomy reversal fails, you will probably need IVF or an alternative reproductive technology.

Several other factors can influence whether your vasectomy reversal is successful. These include:

  • what technique is used,
  • your surgeon’s skill level,
  • how long it’s been since you had your vasectomy,
  • the quality of your vasal fluid,
  • and whether you have any blockage in your epididymis.

If the vasectomy reversal worked, you will have sperm in your semen after the reversal surgery.

Vasovasostomy: If we are able to perform a microsurgical vasovasostomy on each side, men can expect greater than 95 percent chance of having sperm return to their ejaculate.

Vasoepidiymostomy: If we perform the vasoepidiymostomy, there is a 70–90 percent chance of having sperm return to your ejaculate. The main advantage of these microsurgical techniques is that they allow men to become pregnant without needing in-vitro fertilization (IVF).

Recovery

Vasectomy reversals are performed under general anesthesia. You won’t need to stay in the hospital overnight to recover, and you can go home the same day. Patients typically have minimal pain. Most men can manage their pain by using a mild analgesic and applying an ice pack 20 minutes out of every hour. We recommend using a pack of frozen peas.

After surgery, we ask that patients don’t have sex or masturbate for two weeks. We also ask patients to avoid lifting anything heavier than a gallon of milk for two weeks after the reversal.

Things You Should Consider

It’s important for men to have an honest discussion with their partner to decide if having a vasectomy reversal is the best choice for them. If your female partner is older than 40, it may be harder for you and your partner to conceive naturally. In these cases, couples are often better served by having a procedure to extract sperm. Extracted sperm can then be used for assisted reproductive techniques like in-vitro fertilization (IVF). This decision must be made on a case-by-case basis.

Should I Store My Sperm in a Sperm Bank?

We also offer men the option of banking their sperm at the time of their vasectomy reversal. We can collect sperm during a vasectomy reversal by making a small incision (cut) in your testicle to remove some of the seminiferous tubules. This incision is then closed with very fine suture. We will then take your tubules to the andrology lab to extract and freeze your sperm. Your sperm will be placed in liquid nitrogen and can stay in our lab for as long as you’d like.

Benefits of Banking Your Sperm

In rare cases, sperm may not return to your ejaculate after a vasectomy reversal. Your partner or spouse may also have infertility and need IVF. If either of these things happen, you won’t need to have another procedure to extract your sperm. We can extract and then store some of your sperm during your vasectomy reversal.