Vasectomy reversal

Your health expert: Professor Raj Persad, Consultant Urological Surgeon
Content editor review by Pippa Coulter, August 2022
Next review due August 2025

A vasectomy reversal is an operation to reconnect tubes that were cut or sealed in a vasectomy. A successful vasectomy reversal operation means you’ll have sperm in your semen again. However, there’s no guarantee that the operation will restore your fertility or that you will be able to have a successful pregnancy.

About vasectomy reversal

You might be thinking about having a vasectomy reversal if you want to have more children after previously having a vasectomy. Some people decide to have a reversal if they’ve had a lot of pain after a vasectomy. A vasectomy is considered a permanent procedure, so you should only have it if you’re sure you no longer want children. But circumstances do change, and a vasectomy reversal is something you may then want to consider.

A vasectomy involves sealing off a tube in your scrotum called the vas deferens. This means sperm can’t be transported out of your testicles. A vasectomy reversal operation involves reconstructing this tube so that it can carry sperm again.

How successful is vasectomy reversal?

A successful vasectomy reversal operation means you’ll have sperm in your semen and be fertile again. But a vasectomy reversal doesn’t always work. The chances of success for a vasectomy reversal depend on how long it’s been since your original vasectomy procedure. The longer it’s been, the less likely are the chances of success.

Whether or not your vasectomy reversal procedure is successful also depends on several other factors. These include the type of vasectomy you had, what surgery you may have to reverse it, and how experienced your surgeon is. Microsurgery – where your surgeon performs the surgery using a microscope to magnify the tubes – has been shown to have a higher success rate.

A successful vasectomy reversal doesn't guarantee that your partner will get pregnant. The chances of getting pregnant after vasectomy reversal depend on several other things as well as a successful reversal procedure. These include your partner’s age and other causes of both female infertility and male infertility.

The chances of getting pregnant after vasectomy reversal are:

  • 75% if the reversal is within 3 years of the original vasectomy
  • 50–55% if it’s been 3 to 8 years since your vasectomy
  • 40–45% if it’s been 9 to 14 years
  • 30% if it’s been 15 to 19 years
  • less than 10% if your vasectomy was more than 20 years ago

How to get a vasectomy reversal?

It’s a good idea to discuss the fact that you’re considering a vasectomy reversal with your GP. But the procedure is not usually available on the NHS nor is it usually covered by private medical insurance. You’ll need to pay to have the procedure done privately. Your GP may be able to recommend or refer you to a private consultant who performs vasectomy reversal. Or you can search for a consultant yourself.

Costs for vasectomy reversal vary between clinics. They can depend on the experience of the surgeon and the type of procedure you're having. You’ll need to contact a clinic directly to get a quote. Make sure you know exactly what the fee covers, including initial assessments, follow-up and aftercare (including semen analysis after your operation).

You’ll need to book an initial consultation with a private consultant. Your surgeon will want to know about your previous vasectomy and any other surgeries or conditions you may have. They will want to do some tests and examine your genital area too.

Your surgeon will discuss exactly what to expect from a vasectomy reversal. This includes the potential risks and benefits involved. You’ll be asked to sign a consent form before the procedure, so it’s important that you feel fully informed. Be sure to ask your doctor if you have any questions. This should include any details about the surgeon as well as about the procedure. For instance, you may want to ask:

  • questions about your surgeon’s background, training and qualifications
  • how many vasectomy reversal procedures they do each year
  • their success rate
  • if they do microsurgery (carry out the surgery using a microscope)

Preparing for a vasectomy reversal

Your surgeon will explain how to prepare for your procedure. For example, if you smoke, it’s a good idea to quit before your operation. Smoking can increase your risk of infection and other complications after surgery. It can also slow down your recovery.

Vasectomy reversal is usually done under general anaesthesia, which means you’ll be asleep during the procedure. A general anaesthetic can make you sick, so you’ll be asked to stop eating and drinking for several hours before your operation. Make sure you follow any instructions given to you by the clinic.

You can often go home on the day of your procedure, but sometimes you may need to stay overnight, so be prepared for this. If you go home the same day, you’ll need someone to drive you and stay with you overnight.

On the day of your operation, your surgeon will check that you’re still happy to go ahead with the procedure. You may also be given compression stockings to wear, and an injection of an anticlotting medicine called heparin. This helps to prevent blood clots developing in the veins in your legs during surgery.

What happens during a vasectomy reversal operation?

The procedure will usually take between one and three hours, depending on how difficult the surgery is.

Once the anaesthetic has taken effect, your surgeon will make a small cut or cuts (about 2cm long) in your scrotum. They’ll find your vas deferens tube and cut these above and below where they were previously tied or sealed. They’ll then gently open up the tubes and check the fluid inside to see if there’s sperm in it. This shows if there’s any blockage in the tubes where your sperm are stored (the epididymis).

The rest of the procedure will be done in one of the following two ways.

  • If there are sperm in the fluid, this means there’s no blockage. Your surgeon will join the cut ends of your vas deferens back together using dissolvable stitches. This is called a vasovasostomy.
  • If there aren’t any sperm in the fluid, it means there may be a blockage in your epididymis. Your surgeon will join your vas deferens directly to a section of the epididymis that bypasses the block. This is a more complex operation, called a vasoepididymostomy.

In either case, your surgeon may perform the operation using microsurgery – when a microscope is used to magnify the tubes. At the end of the procedure, your surgeon will close your skin with dissolvable stitches.

What to expect afterwards

You’ll need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off. Your doctor may give you an injection called a nerve block to help provide pain relief for a few hours after the operation.

If you’re going home the same day, you’ll need someone to take you home and stay with you for the first 24 hours. Sometimes, you may need to stay in hospital overnight. It can take a while to get over having a general anaesthetic. You might find that you’re not so coordinated or that it’s difficult to think clearly. This should pass within 24 hours. In the meantime, don’t drive, drink alcohol, operate machinery or make any important decisions.

Before you go home, your nurse will give you some advice about caring for the wounds in your scrotum and what pain relief you can take. They may be able to give you extra dressings to take home to use while your wound heals. They’ll also give you information about follow-up appointments.

Recovering from a vasectomy reversal

Take it easy for the first week or so after your procedure. You’re likely to have some swelling, bruising and pain around your scrotum for several days after a vasectomy reversal. If you need to, take over-the-counter painkillers such as paracetamol or ibuprofen. You may find ice packs helpful too, but don’t apply them directly to your skin.

It’s a good idea to wear some form of support such as close-fitting supportive underwear or cycling shorts for the first few days. A scrotal or athletic support would be more supportive and your clinic may provide this. If not, you can buy one at most sports shops or online. It will protect your scrotum and help to ease any discomfort and swelling.

You can do some gentle exercise a week after your procedure. But don’t lift anything heavy or do any strenuous exercise for the first few weeks. It’s best to wait about a month before you have sex again. There’s a risk you could harm the healing (and the success of the reversal) if you have sex before this time. There might be blood in your semen the first few times you ejaculate.

It’s best to wait a couple of days until you have a shower, and a couple of weeks before having a bath. Dry your genital area gently and thoroughly afterwards.

If you have stitches, they’ll usually dissolve within two to three weeks.

Post-surgery sperm tests

It takes an average of three to six months to get good levels of sperm in your ejaculate after a vasectomy reversal. But it may take as long as a year. You’ll need to have your semen tested to find out if it contains sperm. Your doctor will give you instructions about this. You’ll usually be asked to do this around three months after your vasectomy reversal. If you’ve had a vasoepididymostomy, it can take longer for sperm to appear in your semen. Your doctor might need to test your semen every three months.

If sperm haven’t reappeared by a year and a half after your vasectomy reversal, it’s unlikely that the procedure has worked. Your surgeon will talk to you about what your options are next. It might be possible to have more surgery to try to reverse the vasectomy again. Other options include assisted reproductive techniques such as intracytoplasmic sperm injection (ICSI). For more information on this, see our Alternatives section.

Complications of vasectomy reversal

Complications are problems that happen during or after the operation. Possible complications of a vasectomy reversal include the following.

  • Damage to small blood vessels, causing bleeding inside your scrotum. This is called a haematoma and will need further treatment.
  • Infection of your testicles or epididymis. You may need antibiotics for this.
  • Hard lumps in your testicles, called sperm granulomas.
  • Shrinkage of your testicles (testicular atrophy), caused by damage to the blood vessels.
  • The tubes (vas deferens) that carry sperm closing up again, meaning the sperm can’t pass into your semen.

It's possible that the vasectomy reversal procedure doesn’t work. This means you may need to consider further infertility treatments to have a baby.

Alternatives to vasectomy reversal

An alternative to vasectomy reversal is to use an infertility treatment called intracytoplasmic sperm injection (ICSI). This involves surgery to remove sperm directly from your testicle or your epididymis. Your partner will also need a procedure to remove an egg. A single sperm is then injected into your partner’s egg and if the egg is fertilised, it’s transferred to your partner’s womb. As with vasectomy reversal, you’ll usually need to pay for all or some of this treatment.

When possible, vasectomy reversal is thought to be the better approach because of safety issues with ICSI. However, this will depend on a number of things, including:

  • the length of time since your vasectomy
  • how old your partner is
  • the number of children you want
  • the costs involved

In some circumstances, ICSI might be a better option. You can talk to your GP to find out more about fertility treatments or book an appointment directly with a fertility clinic.

It can take several months for sperm to re-appear in your semen, particularly if you’ve had a vasoepididymostomy. Your surgeon may need to keep retesting your semen every few months. If you don’t have semen in your sperm after a year and a half, they may discuss alternative fertility treatments with you. To find out more, see our Recovery section.

This depends on how long it’s been since you had a vasectomy. If it’s within 3 years, the success rate is much higher: around 75 in 100 people go on to have a pregnancy with their partner. This drops to 55 in 100 people if it’s been between 3 and 8 years. However, starting a pregnancy depends on a number of other factors as well as the success of a vasectomy reversal. To find out more, see our About section.

A vasectomy reversal is usually done under general anaesthesia, so you’ll be asleep and won’t feel anything. But you may have some pain once the anaesthetic wears off. Your doctor may give you a nerve block (injection) to help with this. You can also take over-the-counter painkillers and use ice packs as necessary. To find out more, read our Recovery section.

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