Do you want to get pregnant yet your male partner has had a vasectomy? Perhaps he should consider a vasectomy reversal.

What is a vasectomy?
During a vasectomy procedure, a doctor (usually a urologist) blocks or cuts the vas deferens, found on the right and left side of a man’s testicles. This blockage will prevent sperm from travelling through the penis during ejaculation.

A vasectomy is a permanent form of birth control that leads to male sterilization. After a vasectomy, a man is unable to produce sperm to fertilize a woman’s eggs. Thus, he will be unable to get a woman pregnant.

What is a vasectomy reversal?
If your partner had a vasectomy, a vasectomy reversal may allow him to produce sperm to get you pregnant during intercourse.

A vasectomy reversal is a surgical procedure and is done under anesthesia. During a vasectomy reversal, the vas deferens is reconnected. This lets sperm travel from the testes out through the penis during ejaculation.

Types of vasectomy reversals
Before the vasectomy reversal, the surgeon will examine a fluid sample from the end of the vas deferens to check for sperm. If sperm are present, the surgeon will proceed with a vasovasostomy (VV).

If sperm are not visible during this preliminary evaluation, the surgeon will perform a procedure called a vasoepididymostomy (VE). A VE is necessary to overcome any problems or blockages in the epididymis, where the sperm are stored.

A VE is a more complex vasectomy reversal procedure than a VV. The VE has lower success rates. Some men may need both procedures: one done on either side.

Recovery is fast
If your partner has a vasectomy reversal, recovery is usually just a few days. Some men have some pain. However, in most cases of vasectomy reversal, pain medication helps to ease the discomfort.

Also, his doctor will recommend that he refrain from having sex for several weeks after vasectomy reversal. Heavy lifting and physical labor will be restricted until your partner has fully healed. He may have to wear a jockstrap to help him fully recover from the procedure.

Sperm levels after vasectomy reversal
After the vasectomy reversal, your partner will see his physician every few months to make sure his sperm count is normal. After a VV, sperm count and motility may be normal within a few months. After a VE, it may take months to a year for sperm counts to get to normal levels.

Vasectomy reversal versus IVF
You may wonder if vasectomy reversal is necessary for you and your partner in order to get pregnant. After a vasectomy, men have two primary options for getting pregnant again:

  1. They can have a vasectomy reversal.
  2. They can try in vitro fertilization (IVF). During IVF, sperm are surgically removed from your partner and used to fertilize your eggs.

Many couples believe the benefits of a vasectomy reversal outweigh the benefits of IVF to conceive after a vasectomy. Benefits of a vasectomy reversal over IVF include:

  • Once your partner has recovered, he will be fertile for many years while with IVF he will only be able to conceive during that particular IVF cycle.
  • Vasectomy reversal may be more cost-effective than IVF.
  • During IVF, both you and your partner will have multiple procedures and multiple doctor visits; vasectomy reversal will require only your partner’s participation.
  • IVF can sometimes increase the chances of having a pregnancy with multiples, which may increase complications during pregnancy.

In vitro fertilization may be a better option for your partner if:

  • A vasectomy reversal does not work.
  • You have female factor infertility.
  • You are over age 37 and have a limited window of time in which to conceive.

Vasectomy reversal does not guarantee fertility
Unfortunately, vasectomy reversal doesn’t always work. Sometimes the surgeon is unable to reconnect the vas deferens. Normal sperm activity doesn’t resume after vasectomy reversal for some men. However, your partner can repeat vasectomy reversals and let the surgeon try again.

Success Rates

Does your partner want a vasectomy reversal so you can have children?  One in 20 married men have a vasectomy at some point in their lives. For those who want to reverse the procedure and have children, vasectomy reversal success rates are high.

How high are vasectomy reversal success rates?
Vasectomy reversal success rates are based on the percentage of men who conceive after a vasectomy, which ranges from 20 to 75 percent. These success rates depend on the type of procedure for the vasectomy reversal, whether a vasovasostomy (VV) or a vasoepididymostomy (VE).

Vasectomy reversal success rates range from 50 to 70 percent of men who have a child after a vasovasostomy (VV). With a vasoepididymostomy (VE), men have lower success rates of 20 to 40 percent having a child. Even though vasectomy reversal success rates are lower with the VE, some men must have the VE during their vasectomy reversal.

Vasectomy reversal success rates
At the beginning of a vasectomy reversal, the doctor will take a sample of fluid from your partner’s vas deferens. The doctor will check for the presence of sperm and also examine its consistency. If the doctor does not see any sperm in the fluid, a vasoepididymostomy (VE) will be necessary because of a blocked epididymis.

Vasectomy reversal success rates are highest when the sample fluid is clear. With cloudy, thick or creamy fluid, the success rates decrease.

After the vasectomy reversal
After a vasectomy reversal, the doctor will do a semen analysis at different appointments over several months. Each time, the doctor will check to see if the sperm are mobile and have returned to normal levels.

If your partner’s sperm levels appear to be normal, but you have not gotten pregnant within 1 to 2 years, the doctor may do further testing, including checking for antisperm antibodies. Some doctors believe that these antibodies might lower vasectomy reversal success rates.

If the sperm analysis is abnormal six months after a VV and 18 months after a VE, the doctor can discuss other options with you and your partner such as in vitro fertilization (IVF) or a repeat of the vasectomy reversal.

How to measure success
If you and your partner get pregnant within months after a VV or VE, then your vasectomy reversal success rate is superb!

Most couples take about a year to get pregnant after a vasectomy reversal. Although a few couples conceive after several months, others take several years to conceive and bring home a baby.

Success depends on the couple
Vasectomy reversal success rates are higher in couples that have already achieved a healthy pregnancy together.

Before your partner opts for a vasectomy reversal, you both should talk with the doctor about your health, your fertility risk factors, and the odds of conceiving. Your age and reproductive health play a major role in whether you can conceive after your partner’s vasectomy reversal.

Boost your vasectomy reversal success rate
To boost the chance of conceiving, make sure the urologist is both knowledgeable and experienced in performing vasectomy reversals.

Time is an important factor. When the reversal is done closer to the time of the original vasectomy, the vasectomy reversal success rates are higher.  Some research shows that men undergoing vasectomy reversal 15 years or more after a vasectomy will have a lower chance of success than men who do it earlier.

 

Sources

  • American Pregnancy Association: Intracytoplasmic Sperm Injection: ICSI
  • American Society of Reproductive Medicine: management of infertility due to obstructive azoospermia
  • American Urological Association Foundation: Vasectomy Reversal
  • Report on Management of Obstructive Azoospermia
  • NIH Facts About Vasectomy Safety