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5 Things to Know About Vasectomy Reversals

August 12, 2024

For many men, a vasectomy is a reliable choice for long-term contraception. But what happens if life changes and you decide you want children again?

The good news is that vasectomy reversal is possible. However, its success depends on several factors.

Here are five things you should know if you’re considering a vasectomy reversal.

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1. Vasectomy reversals require surgery.

Unlike a vasectomy, which is typically performed in a doctor’s office, reversals often require an operating room setting for optimal outcomes.

“A reversal will take about three hours and success rates are generally high,” explains Jared Bieniek, MD, medical director and fellowship-trained microsurgeon at Tallwood Men’s Health.

Because it’s a more involved procedure, it’s important you find the right surgeon.

“Reversals require expertise so patients should seek out a provider with specific training and experience performing reversals for their best outcome.”

> Related: What Happens When You Get a Vasectomy? What to Expect Before, During and After

2. Your doctor will choose the best approach during surgery.

During a vasectomy, the vas deferens is cut and sealed on both sides, preventing sperm from entering the semen. A reversal involves reconnecting the vas deferens, which can be complicated by the presence of scar tissue.

If the reversal is straightforward, the vas deferens is connected back together with tiny sutures.

But if there’s a blockage that needs to be bypassed, the vas deferens may be connected directly to the epididymis in the testicles.

Your doctor will decide which reconstruction is most appropriate during surgery.

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3. Vasectomy reversal isn’t always covered by insurance

Vasectomies are often covered by insurance, but reversals are not always.

Be sure to consult with your own plan regarding coverage.

4. Sooner is better, when it comes to outcomes.

While there is no time limit for vasectomy reversal, men who have the procedure sooner after their vasectomy tend to have higher success rates.

“After more than approximately 10 years, other changes may have occurred that we won’t know about until we are in the operating room, such as whether the vas deferens is still open and can be reconnected or if a more complex reconstruction is needed,” says Dr. Bieniek.

But that doesn’t mean you’re out of luck if you wait too long.

“Certainly there is no line in the sand however, and some men can restore fertility even multiple decades after their vasectomy.”

5. There are other fertility options besides vasectomy reversal.

If you’re not the right candidate for vasectomy reversal, there are other fertility options you can discuss with your doctor.

Options include retrieving sperm from the epididymis or testicle for use with in vitro fertilization.

Before a reversal, Dr. Bieniek gathers information about the patient’s fertility, such as if he has fathered children before.

“We also consider their current partner – is it the same partner they have successfully conceived with before or a different partner?” he explains.

If it’s a new partner, a fertility history is obtained to estimate future fertility potential and to determine if a vasectomy reversal or sperm retrieval may be the better option.

“Reversals are an excellent option for men looking to restore fertility after a vasectomy. They have high success rates but may not be the right choice for everyone,” Dr. Bieniek says.