Condition & Treatments
/ Vasectomy reversal
Had a vasectomy and want children again? Microsurgical reversal can restore your fertility.
A vasectomy reversal reconnects the tubes cut during your vasectomy, so sperm can reach the semen again and you can try to conceive naturally. It is microsurgery, and the surgeon's experience makes a real difference to the result.
I N S H O R T
Most reversals reconnect the two ends of the vas (vasovasostomy).
If there is a second blockage further back, the vas is joined directly to the epididymis (epididymovasostomy), a more delicate operation.
Success depends mainly on how long ago the vasectomy was done, and on your partner's age.
Before you decide
There are two routes to a pregnancy after vasectomy: reversal, or sperm retrieval with IVF/ICSI. Reversal allows natural conception and more than one child. IVF may be quicker if your partner is older or has her own fertility issues. Prof Raheem will help you compare both honestly.
The operation
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Under general anaesthetic, as a day case, using an operating microscope.
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Prof Raheem examines the fluid from the vas during surgery to decide which type of join is needed.
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Sperm can be frozen during the same operation, as a back-up for IVF.
Why this matters to your care
Prof Raheem is trained in both vasovasostomy and epididymovasostomy, so the right repair can be done in the same operation, rather than stopping if a second blockage is found. He has presented outcome studies of both operations at international urology meetings.
Common questions
How successful is it?
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It depends mainly on how long ago your vasectomy was. In the largest study, of 1,469 men, sperm returned to the semen in 97% and pregnancy followed in 76% when the vasectomy was under 3 years ago; 88% and 53% at 3–8 years; 79% and 44% at 9–14 years; and 71% and 30% at 15 years or more [1]. Prof Raheem's own results are in line with these published figures.
How soon can we try?
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Most men can have sex again after about 3 weeks. After a vasovasostomy, sperm usually returns within 2 to 4 months; after an epididymovasostomy it takes longer, often around 6 months or more [2, 3]
Is it too late if my vasectomy was over 10 years ago?
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Not necessarily. Success falls with time, but even 15 years or more after vasectomy, sperm returned in 71% of men and 30% of couples conceived in the largest study [1]. Some men need an epididymovasostomy.
Prof Raheem's published work on this topic
Complications of male fertility surgery (book chapter). Complications and Outcomes of Assisted Reproduction. Cambridge University Press, 2017
References
1. Belker AM, Thomas AJ Jr, Fuchs EF, Konnak JW, Sharlip ID. Results of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group. Journal of Urology, 1991;145(3):505–511. Link
2. Matthews GJ, Schlegel PN, Goldstein M. Patency following microsurgical vasoepididymostomy and vasovasostomy: temporal considerations. Journal of Urology, 1995;154(6). Link
3. The kinetics of sperm return and late failure following vasovasostomy or vasoepididymostomy: a systematic review. Journal of Urology, 2019. Link