A vasectomy is a type of surgery in which your doctor cuts the vas deferens. This tube connects your sperm-producing testicles to your penis for ejaculation. Your testicles can still produce sperm, but they won’t get into the semen that’s produced when you ejaculate.
A vasectomy reversal reverses the effects of a vasectomy. This is done by reattaching the vas deferens to your penis so that you can ejaculate sperm again. People have many reasons for wanting a vasectomy reversal, including:
- having children again after losing a child or partner
- changing their mind about having children later in life
- having children with a new partner after a divorce or breakup
- having more stability or resources to begin a family or support a larger family
- having pain in their testicles related to a vasectomy
Vasectomies may be reversible up to 20 years or longer after the initial procedure. But the longer you wait to reverse a vasectomy, the less likely that you’ll be able to have a child after the procedure.
If your partner has had a tubal ligation, a vasectomy reversal won’t increase your chances of getting your partner pregnant. You may want to ask your doctor about in vitro fertilization and sperm aspiration.
Sperm usually start appearing in your semen again a few months after a vasectomy reversal. This increases your chances of getting your partner pregnant. You may need to wait a year or longer before sperm appear again. This may be necessary if your doctor finds any blockage in your vas deferens or epididymis.
Your chances of getting your partner pregnant after reversing a vasectomy can range from 30 to 70 percent. Your chances of a successful reversal may be lower if it’s been over 10 years since your vasectomy.
Other factors that may affect your ability to have children include:
- your age
- your partner’s age
- your fertility
- your partner’s fertility
- sperm blockage due to scar tissue in the vas deferens or epididymis, the tubes that carries sperm from your testicles into the vas deferens
- how qualified and experienced your surgeon is in performing the reversal
Your chance of getting your partner pregnant increases significantly after having this procedure done.
Having a low sperm count can make it more difficult to get your partner pregnant. Talk to your doctor about getting your sperm count tested. A sperm count between 15 and 200 million for every milliliter of semen is considered normal. Your sperm’s movement, known as their motility, can also affect your chances of getting your partner pregnant. Talk to your doctor about ways you may be able to increase your sperm count and boost fertility.
Not having any sperm in your semen is known as azoospermia. In this case, you may not be able to get your partner pregnant, even with a vasectomy reversal.
A vasectomy reversal is an outpatient procedure that’s usually completed in 30–60 minutes. It can be done with local anesthesia that numbs the area around your scrotum, the sac that holds your testicles. It can also be done with general anesthesia that keeps you unconscious throughout the surgery.
Your surgeon will use one or both of the following procedures:
- Vasovasostomy: Your surgeon takes the two ends of your vas deferens that were cut apart during your vasectomy and stitches them back together.
- Vasoepididymostomy: Your surgeon stitches the vas deferens to the epididymis. Your surgeon may do this procedure instead of a regular vasovasostomy if there’s scar tissue blocking sperm from moving into your vas deferens or if a vasovasostomy won’t reverse the vasectomy.
Your surgeon may perform both procedures if the area around each testicle requires different techniques to allow the vas deferens tubes to carry sperm into your penis again.
Both procedures are done using similar steps:
- Your surgeon makes an incision on the bottom of your scrotum to get to the vas deferens.
- Your surgeon opens your vas deferens and checks the fluid within the tube. Your surgeon then does a vasovasostomy if there are sperm in the fluid. If there aren’t any sperm or if the fluid is abnormally thick, your surgeon will do a vasoepididyostomy.
- Your surgeon closes the incision with stitches, or sutures, and bandages your scrotum to stop any bleeding.
A vasectomy reversal may take longer than a vasectomy. This is because of the additional steps involved in reattaching the two ends of the vas deferens to each other.
Your doctor may give you an ice pack or cold compress after surgery. This helps keep your scrotum from swelling. You may also be asked to wear tight underwear. This keeps your scrotum from moving around too much so that the incision doesn’t open back up.
You should be able to go home a few hours after the surgery. Once you go home, take care of the area where the surgery was performed by doing the following:
- Take a few days off work and limit all physical activities to allow yourself time to heal, especially if you work in a labor-intensive job.
- Don’t get the incision area wet for a few days after surgery.
- Don’t do any physical activity that could strain the area around your scrotum, such as jogging or biking.
- Don’t have sex for a few weeks after the surgery or until your doctor tells you it’s safe to resume sexual activities.
- Wear tight underwear for a few weeks until the incision heals.
- Take nonsteroidal anti-inflammatory drugs (NSAIDs) for any pain.
As with any surgery, some complications are possible. See your doctor if you experience any of the following:
- pain or redness around the incision
- pus or bleeding from the incision
- fever over 100°F (38°C)
- hematoma (blood in the scrotum, which usually looks like a large purple spot)
- loss of feeling around your scrotum
If you get a vasectomy reversal less than 10 years after a vasectomy, you’re much more likely to be able to get your partner pregnant once sperm start appearing in your semen again.
Talk to your doctor about any factors that might affect your ability to get your partner pregnant. In some cases, a vasectomy reversal may not work if other factors, such as your sperm count and motility as well as your partner’s age, are preventing you from getting them pregnant.