Some women get pregnant in the first few months, while others may take years. Pregnancy rates can depend on the amount of time between the vasectomy and reversal.
Sperm return to the semen faster and pregnancy rates are highest when the reversal is done sooner after the vasectomy. Next to pregnancy, testing the sperm count is the only way to tell if the surgery worked. Your urologist will test your semen every 2 to 3 months until your sperm count holds steady or your partner gets pregnant.
Sperm often appear in the semen within a few months after a vasovasostomy. It may take from 3 to 15 months after a vasoepididymostomy. In either case, if the reversal works, you should stay fertile for many years. Only about 5 out of men later get scars in the reconnected part. The scars could block the outflow of sperm all over again.
Vasectomy reversals are most often done by urologists, but not all urologists do this type of surgery often. This technique calls for extra training and expertise. Almost all vasectomies can be reversed. But if the vasectomy was done while fixing a hernia in the groin it may not be as easy to join the ends of the vas.
The ends also may not be able to be joined if a very long piece was removed during the vasectomy, but this is rare. You can't tell before the reversal which method is best for you.
Your urologist can only find this out during the surgery. If sperm are found in the vasal fluid, then a vasovasostomy is done. If there are no sperm in the fluid, your urologist will decide what to do based on other factors. If there's a block in the epididymal tube, then a vasoepididymostomy will be needed.
If no block is found, then the way the vasal fluid looks may help your urologist decide which method is best. Fluid that looks creamy without sperm suggests that vasoepididymostomy is needed. Some patients may need a vasovasostomy on one side and a vasoepididymostomy on the other. Your age shouldn't affect the results of your vasectomy reversal. Most men keep making sperm for many years after their partners stop making eggs.
Women become less fertile starting in their mids, with a major drop around age Your partner should check with her gynecologist to see if she is still ovulating before you agree to a reversal. There are other ways to get your partner pregnant without a reversal. Your urologist can take sperm from your testis or epididymis using a needle or by surgery "sperm retrieval".
But sperm taken this way can't be used in basic, low-cost office artificial inseminations. The pregnancy rates are much lower if she is older. Your choice may be influenced by which methods your health plan covers.
You might also weigh cost, years since vasectomy and the chance of needing an epididymovasostomy , and your partner's age. When done by skilled microsurgeons, success rates for repeat reversals are often the same as for first reversals. Your urologist will review the record of your prior surgery to help you decide.
Most health plans don't pay for reversals. 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. 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.
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. 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.
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. 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.
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. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Top of the page. Surgery Overview A vasectomy is considered a permanent method of birth control. What To Expect After Surgery Vasectomy reversal usually takes from 2 to 4 hours, followed by a few more hours for recovery from the anesthetic.
Why It Is Done Vasectomy reversal is done when you have had a vasectomy and now want to be fertile. How Well It Works Chances of a successful vasectomy reversal decline over time. Has the greatest chance of success within 3 years of the vasectomy.
Risks Risks of vasectomy reversal include: Infection at the site of surgery. Fluid buildup in the scrotum hydrocele that may require draining. Injury to the arteries or nerves in the scrotum. What To Think About Before a vasectomy reversal is done, your doctor will want to confirm that you were fertile before your vasectomy.
Female and male sterilization. In RA Hatcher, et al. New York: Ardent Media.
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