Vasectomy reversal - Mayo Clinic (2022)

Overview

Vasectomy reversal is surgery to undo a vasectomy. During the procedure, a surgeon reconnects each tube (vas deferens) that carries sperm from a testicle into the semen. After a successful vasectomy reversal, sperm are again present in the semen, and you may be able to get your partner pregnant.

Pregnancy rates after vasectomy reversal will range from about 30% to over 90%, depending on the type of procedure. Many factors affect whether a reversal is successful in achieving pregnancy, including time since a vasectomy, partner age, surgeon experience and training, and whether you had fertility issues before your vasectomy.

Why it's done

Deciding to have a vasectomy reversal may happen for several reasons, including loss of a child, a change of heart or remarriage, or to treat chronic testicular pain after vasectomy.

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(Video) Vasectomy reversal and male infertility: Mayo Clinic Radio

Risks

Almost all vasectomies can be reversed. However, this doesn't guarantee success in conceiving a child. Vasectomy reversal can be attempted even if several years have passed since the original vasectomy — but the longer it has been, the less likely it is that the reversal will work.

Vasectomy reversal rarely leads to serious complications. Risks include:

  • Bleeding within the scrotum. This can lead to a collection of blood (hematoma) that causes painful swelling. You can reduce the risk of hematoma by following your doctor's instructions to rest, use scrotal support and apply ice packs after surgery. Ask your doctor if you need to avoid aspirin or other types of blood-thinning medication before and after surgery.
  • Infection at the surgery site. Although very uncommon, infections are a risk with any surgery and may require treatment with antibiotics.
  • Chronic pain. Persistent pain after vasectomy reversal is uncommon.

How you prepare

When considering vasectomy reversal, here are a few things to think about:

  • Vasectomy reversal may be expensive, and your insurance might not cover it. Find out about costs ahead of time.
  • Vasectomy reversals are generally most successful when they're done by a surgeon who is trained in and uses microsurgical techniques, including those that make use of a surgical microscope.
  • The procedure is most successful when performed by a surgeon who does the procedure regularly and who has done the procedure many times.
  • The procedure occasionally requires a more complex type of repair, known as a vasoepididymostomy. Make sure that your surgeon is able to perform this procedure if it's required.

When choosing a doctor, don't be afraid to ask questions about how many vasectomy reversals the doctor has done, the type of techniques used and how often the vasectomy reversals have resulted in pregnancy. Also ask about the risks and potential complications of the procedure.

Food and medications

Make sure you know what steps you need to take before surgery. Your doctor will probably ask you to stop taking certain medications, including blood-thinning medications and pain relievers, such as aspirin or ibuprofen (Advil, Motrin IB, others), because they can increase your risk of bleeding.

Clothing and personal items

Bring tightfitting undergarments, such as an athletic supporter, to wear after surgery. This will support your scrotum and hold bandages in place.

Other precautions

Arrange for someone to drive you home after surgery. Surgery generally takes about two to four hours or longer. You may need additional time to recover if the procedure is done with general anesthesia. Ask your doctor when you can expect to go home after surgery.

What you can expect

Vasectomy reversal

Vasectomy reversal - Mayo Clinic (1)

Vasectomy reversal

A vasectomy reversal reconnects the severed vas deferens, the tube that carries sperm from each testicle. During a vasectomy reversal, the severed ends of the vas deferens are reattached to one another. In some cases, the vas deferens may be attached directly to the epididymis — the part of the testicle where sperm matures.

(Video) Men's Health Moment: Vasectomy Reversal: Alternatives

Before the procedure

Before vasectomy reversal surgery, your doctor will likely want to:

  • Take your history and perform a physical exam. Your doctor will want to make sure that you don't have health concerns that could complicate surgery.
  • Check to see whether you can produce healthy sperm. For most men, having fathered a child before is proof enough. After your vasectomy, your testicles continued to produce sperm. But the amount of sperm that you produce may have decreased over time. Age, diet, exercise, smoking and other things can change how much healthy sperm you can produce. To be sure, your doctor may want to perform some tests before surgery.
  • Confirm that your partner is capable of having a child. Your doctor will want to see whether your partner has any fertility problems, especially if your partner has never had a child or is older than age 40. This may require a gynecological exam and other tests.

Doctors usually perform vasectomy reversals at a surgery center or hospital. The procedure is generally done on an outpatient basis — without an overnight stay. Some surgeons can do the surgery in the clinic, but you'll want to make sure that the surgeon is able to do a more complex repair (vasoepididymostomy) in the clinic, if that becomes necessary.

Your doctor may use general anesthesia to make you unconscious during surgery. Or your surgeon may give you an anesthetic that keeps you from feeling pain but doesn't put you to sleep — such as a local anesthetic.

Vasectomy reversal is more difficult than a vasectomy and should be done using microsurgery, in which a surgeon uses a powerful surgical microscope to magnify the vas deferens as much as 40 times its size. This type of surgery requires specialized skills and expertise.

Doctors performing this surgery usually will reattach the vas deferens in one of two ways:

  • Vasovasostomy (vas-o-vay-ZOS-tuh-me). With this procedure, the surgeon sews back together the severed ends of each tube that carries sperm (vas deferens).
  • Vasoepididymostomy (vas-o-ep-ih-did-ih-MOS-tuh-me). This surgery attaches the vas deferens directly to the small organ at the back of each testicle that holds sperm (epididymis). A vasoepididymostomy is more complicated than a vasovasostomy and is generally chosen if a vasovasostomy can't be done or isn't likely to work.

The decision to perform a vasovasostomy versus a vasoepididymostomy depends on whether sperm are seen when fluid from the vas deferens is analyzed at the time of surgery.

It is not possible to know ahead of time which procedure is needed. In most cases, the surgeon decides during the operation which technique will work best. Sometimes a combination of the two surgical techniques is needed — a vasovasostomy on one side and a vasoepididymostomy on the other. The longer it has been since your vasectomy, the more likely you are to need a vasoepididymostomy on one or both sides.

(Video) Mayo Clinic Minute: Reversing a vasectomy

Vasovasostomy

Epididymovasostomy

During the procedure

During surgery, your doctor will make a small cut (incision) on your scrotum. This will expose the tube that carries sperm (vas deferens) and release it from surrounding tissues.

Next, the doctor will cut open the vas deferens and examine the fluid inside. When sperm are present in the fluid, the ends of the vas deferens can be connected to reestablish the passageway for sperm.

If the fluid contains no sperm, scar tissue may be blocking sperm flow. In this case, your doctor may choose to perform a vasoepididymostomy.

Robot-assisted surgery has been used for vasectomy reversal but usually is required only in select cases.

After the procedure

Immediately after surgery, your doctor will cover the incision with bandages. You'll put on tightfitting undergarments, such as an athletic supporter, and apply ice for 24 to 48 hours to reduce swelling.

You may be sore for several days. If your doctor places bandages over the incision after your surgery, ask when it's OK to take them off. Any stitches should dissolve in seven to 10 days.

After you return home, take it easy and try to limit activities that might cause the testicles to move around excessively. As the anesthetic wears off, you may have some pain and swelling. For most men, the pain isn't severe and gets better after a few days to a week.

(Video) Men's Health Moment: Vasectomy Reversal: Overview

Your doctor may also give you the following instructions:

  • For several weeks, wear an athletic supporter except when showering. After that, you'll need to continue to wear one when you exercise.
  • For the first two days after surgery, avoid anything that might get the surgery site wet, such as bathing or swimming.
  • Limit any activities that may pull on the testicles or scrotum, such as jogging, sporting activities, biking or heavy lifting, for at least six to eight weeks after surgery.
  • If you have a desk job, you'll probably be able to return to work a few days after surgery. If you perform physical labor or have a job that requires much walking or driving, talk to your doctor about when it's safe to go back to work.
  • Don't have sexual intercourse or ejaculate until your doctor says it's OK. Most men need to refrain from ejaculating for two to three weeks after surgery.

Freezing sperm

Although it's usually not required or recommended, you may choose to have sperm frozen (cryopreservation) in case your vasectomy reversal doesn't work. If you're not able to father a child through sexual intercourse, you may still be able to have children through assisted reproductive technology such as in vitro fertilization.

Results

Sometime after surgery, your doctor will examine your semen under a microscope to see if the operation was successful.

Your doctor may want to check your semen periodically. Unless you get your partner pregnant, checking your semen for sperm is the only way to tell if your vasectomy reversal was a success.

When a vasectomy reversal is successful, sperm may appear in the semen within a few weeks, but it can sometimes take a year or more. The likelihood of achieving pregnancy depends on various factors, including the number and quality of sperm present and the female partner's age.

If the vasectomy reversal doesn't work

Vasectomy reversals sometimes fail if there is an underlying issue with the testicle that cannot be recognized during surgery or if a blockage develops sometime after surgery. Some men have a second-attempt vasectomy reversal surgery if the procedure doesn't work the first time. Success rates are slightly lower for the second attempt than for the initial attempt.

You may also be able to father a child through in vitro fertilization by using frozen sperm. Sperm may be retrieved directly from the testicle or epididymis either at the time of the reversal surgery or at a later date. Doctors don't usually recommend freezing sperm at the time of reversal surgery, as it may be an unnecessary extra procedure.

By Mayo Clinic Staff

(Video) Men's Health Moment: Vasectomy Reversal: Questions to Ask Your Surgeon Before Vasectomy Reversal

Aug. 20, 2021

FAQs

How successful is a vasectomy reversal? ›

Success rates for vasectomy reversal

It's estimated that the success rate of a vasectomy reversal is: 75% if you have your vasectomy reversed within 3 years. up to 55% after 3 to 8 years. between 40% and 45% after 9 to 14 years.

Are there side effects to reversing a vasectomy? ›

Vasectomy reversal rarely leads to serious complications. Risks include: Bleeding within the scrotum. This can lead to a collection of blood (hematoma) that causes painful swelling.

What are the chances of getting pregnant after a vasectomy reversal? ›

Time from the vasectomy certainly helps to predict how likely it would be to be able to put the two ends of the vas deferens back together; however, getting return of sperm into the ejaculate does not guarantee pregnancy, so pregnancy rates typically vary from 30 to 70 percent, whereas patency rate, that is the return ...

What percentage of vasectomies Cannot be reversed? ›

Up to 10% of men who've had vasectomies opt for a reversal. You've learned that life circumstances can change unexpectedly, and your thoughts about having children or more children have changed.

Where does sperm go after vasectomy? ›

The urethra is the tube inside the penis. Once they are cut, sperm can't get into the semen or out of the body. The testes still make sperm, but the sperm die and are absorbed by the body.

How much does it cost to extract sperm after vasectomy? ›

If it is performed in a hospital or surgicenter, the costs are generally much higher than if it is done in an office. The total cost of a sperm aspiration including freezing will generally be somewhere between $3000 and $12,000 – depending on the variables mentioned above.

Are vasectomies 100% effective? ›

They are extremely effective

Masson. After abstinence, vasectomies are considered the most effective method of birth control due to their long-term success rate of over 99%.

Is it possible to have a baby after vasectomy? ›

After your vasectomy, if you change your mind about having children, there are two procedures that can help you have a child with your partner. The two options are: a vasectomy reversal or sperm aspiration prior to in vitro fertilization (IVF).

What color is sperm after vasectomy? ›

Your semen will look just like it did before your vasectomy. Usually, semen has the consistency of thin mucus and a clear, gray, or white, opalescent color. Since the sperm makes up a very small volume of the semen, you won't notice a change in the amount you ejaculate.

Can you get an erection without testes? ›

Without both testicles, your body won't be able to make as much testosterone as it needs. That might lower your sex drive and make it harder to have erections.

What is the liquid that comes out of a guy before sperm? ›

Pre-cum (also known as pre-ejaculate) is a small amount of fluid that comes out of your penis when you're turned on, but before you ejaculate (cum). Oozing pre-cum is involuntary — you can't control when it comes out. Pre-cum doesn't usually have any sperm in it.

How often should a man release sperm? ›

It is completely healthy to ejaculate more or less than three times a week! The average ejaculation frequency for men ranges from two to seven times a week, which is a pretty wide gap. So it's clear that there's no right or wrong answer, nor are there any significant health risks associated with ejaculation frequency.

Which is better vasectomy reversal or IVF? ›

Vasectomy reversal is often the better choice over in vitro fertilization (IVF). Reversing vasectomy is more affordable and more successful than in vitro fertilization.

How do men get sperm for IVF? ›

Testicular sperm aspiration (TESA)

TESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI. It is done with local anesthesia in the operating room or office and is coordinated with their female partner's egg retrieval. A needle is inserted in the testicle and tissue/sperm are aspirated.

How long does it take for sperm to return after vasectomy reversal? ›

It can take up to 6 – 12 months for sperm to return to the ejaculate following a vasovasostomy and longer following an epididymovasostomy (up to 18 months). However, in the vast majority of patients, sperm will be seen in the ejaculate three months after vasovasostomy.

How can I get pregnant if my husband had a vasectomy? ›

How to get pregnant after a Vasectomy. To be able to have children after a vasectomy you can undergo a vasectomy reversal or try In vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI) using aspirated sperm.

Why is vasectomy not preferred? ›

The vasectomy's appeal remains limited because the procedure is often permanent and offers no protection against sexually transmitted diseases like AIDS, experts say. But even many men with only one sex partner who are at low risk of disease and who do not want more children shun the procedure.

How many ejaculations after vasectomy are sterile? ›

The life cycle of sperm is 63 days. 80% of men will be sterile after 15 ejaculations or 6 weeks after a vasectomy. By 10 weeks, 85% of men will have no sperm in the ejaculate. Therefore, a safe time period to say would be approximately 3 months (12 weeks) after vasectomy with about 20 ejaculations.

How long does a vasectomy last? ›

Vasectomy surgery usually takes about 10 to 30 minutes.

Can you donate sperm after vasectomy? ›

Yes it does make you sterile and your semen has no sperm. So you cannot be a sperm donor.

Can a vasectomy grow back years later? ›

Share on Pinterest Recanalization reverses a vasectomy. It is also possible for a vasectomy to fail weeks, months, or even years after the procedure through a process called recanalization. Recanalization happens when the vas deferens grow back to create a new connection, causing the vasectomy to reverse itself.

Why is there white chunks in my sperm? ›

It is normally thick, sticky and clumpy on ejaculation due to the protein it contains as these help it to 'stick' higher in the vagina and slow down the rate it drips out, so increasing the chances of fertilisation occurring. Semen is normally thick, sticky and clumpy on ejaculation due to the protein it contains.

Why is my sperm thick and jelly? ›

Thick semen usually results from a higher than normal concentration of sperm in a typical volume of semen, or from having a high number of sperm with an irregular shape (morphology). High sperm concentration often indicates that you're more likely to impregnate a female partner.

Does a vasectomy affect size? ›

Men who have a vasectomy still ejaculate the same way in the same amounts – the only difference is that there is no sperm in the semen. The size, shape of look of the penis, testicles and scrotum is unchanged.

Can a vasectomy fail after 5 years? ›

Researchers estimated that around one in 100 vasectomies would fail within one to five years of surgery. They say those failure rates are similar to those reported in two prior studies on vasectomy failure.

How often does a vasectomy fail? ›

One of the most significant pros of a vasectomy is that a vasectomy is a very effective and permanent form of birth control. Only one to two in 1,000 men have a vasectomy that fails. This usually happens in the first year following the procedure.

Are all vasectomies permanent? ›

Before getting a vasectomy you need to be certain you don't want to father a child in the future. Although vasectomy reversals are possible, vasectomy should be considered a permanent form of male birth control.

Can sperm be extracted after vasectomy? ›

There are two ways to restore a man's fertility after a vasectomy. One is vasectomy reversal. The other is to withdraw sperm from the testicle, inject it into an egg in the lab, and fertilize the egg, a procedure called sperm aspiration with ICSI and IVF.

How can I get pregnant if my husband had a vasectomy? ›

How to get pregnant after a Vasectomy. To be able to have children after a vasectomy you can undergo a vasectomy reversal or try In vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI) using aspirated sperm.

How often should a vasectomy be checked? ›

Follow your clinician's instructions about how long to wait after your vasectomy before performing the sperm count tests. The usual recommendation is to perform two (2) tests within 2-4 months following the procedure, and then once a year thereafter. The results of both tests should be negative.

How effective is the pull out method? ›

For every 100 people who use the pull out method perfectly, 4 will get pregnant. But pulling out can be difficult to do perfectly. So in real life, about 22 out of 100 people who use withdrawal get pregnant every year — that's about 1 in 5.

Can you have a baby if you have had a vasectomy? ›

Children after a vasectomy are possible with or without medical intervention. According to reports, pregnancy occurs every 1 to 4,000 procedures. If you decide to opt for medical care, whether it be through vasectomy reversal or sperm extraction, the chance of pregnancy from 0.5% to up to 60 to 80%.

Can a man with a vasectomy get a woman pregnant? ›

Vasectomy is very effective at preventing pregnancy, but it's also permanent. While pregnancy after vasectomy is possible, it's pretty rare. When it does happen, it's usually the result of not following postsurgery guidelines or a surgical mistake.

What color is sperm after vasectomy? ›

Your semen will look just like it did before your vasectomy. Usually, semen has the consistency of thin mucus and a clear, gray, or white, opalescent color. Since the sperm makes up a very small volume of the semen, you won't notice a change in the amount you ejaculate.

How does a man give sperm for IVF? ›

Testicular sperm aspiration (TESA)

TESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI. It is done with local anesthesia in the operating room or office and is coordinated with their female partner's egg retrieval. A needle is inserted in the testicle and tissue/sperm are aspirated.

Is sperm retrieval painful? ›

You do not feel any pain, and you do not remember the procedure afterwards. If PVS or EEJ don't work, a sperm retrieval method from the epididymis or testicle may be needed.

Videos

1. Men's Health Moment: Vasectomy Reversal: Success Rates
(Mayo Clinic)
2. Vasovasostomy - Mayo Clinic
(Mayo Clinic)
3. Mayo Clinic Minute: Why a vasectomy is a great option for birth control
(Mayo Clinic)
4. How a vasectomy reversal is carried out
(Bupa Health UK)
5. Vasectomy Reversal: Fertility Options After Vasectomy | Jesse Mills, MD | UCLAMDChat
(UCLA Health)
6. Vasectomy: Mayo Clinic Radio
(Mayo Clinic)

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