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Can a Vasectomy Be Reversed?

Yes, but success depends on how skilled the surgeon is.

Question:

Can a vasectomy be reversed?

Answer:

Yes. Over the past 35 years, improvement and refinements in technique, instruments, and microsutures have made a microsurgical vasectomy reversal highly successful. Approximately 1 out of 20 men will seek a reversal during their lifetime. For most men seeking to father children again after a vasectomy, 85%-90% can have the flow of sperm restored. Of those, more than two-thirds can father children again.

A recent study confirmed that the single most important predictor of a successful reversal is the skill and expertise of the microsurgeon. It is essential that couples take the time to do research before they proceed. Be cautious with anyone that says that he/she can do the reversal, even if recommended by a doctor. This is a surgical procedure that should only be performed by a dedicated microsurgical master that is consistently performing at least 2-3 surgeries per week.

The second most important variable in determining success of a reversal is the age of the female partner. We know that as a woman approaches age 40, her ability to conceive declines. Anyone considering a reversal should be sure to have their female partner evaluated to see if she is still able to become pregnant. Once she is medically cleared, then it is simply a matter of finding the right microsurgeon.

A lesser factor affecting reversal success is the number of years since the vasectomy. As time passes, the fluid, which is still produced, builds up under pressure and can damage the delicate tubules where sperm develop and mature. If a "blow-out" occurs, then the microsurgeon will need to perform a bypass procedure (vasoepididymostomy or VE), technically even more difficult to perform than the standard repair (vasovasostomy or VV). For this reason, it is critical that you select a microsurgeon that is skilled and experienced in performing whatever procedures you need to result in a return of fertility.

The intricate reconnection of the two ends of the vas normally takes about two to three hours and is usually performed with either conscious sedation or general anesthesia. The cost for a vasectomy reversal varies widely, from about $6,000-$18,000, depending on the facility and location. Academic programs and centers located in large metropolitan areas usually charge more than private surgeons and programs in smaller cities. There is no correlation between cost, location, and outcomes, so cost and location should not generally be used as criteria for selecting a surgeon.

Choosing a microsurgeon is highly personal. As with any elective surgery, your chances for success are dramatically higher when you take the time to do research and select the microsurgeon that is best for you.