Overview
What is it?
A vasectomy reversal is where the tubes that carry the sperm (the vas) are reconnected to allow sperm to flow into the semen.
How effective is it?
While a vasectomy is highly effective, a reversal of this is not. Evidence shows that if a reversal is carried out within 10 years of a vasectomy, the success rate is around 55%. If the reversal is carried out more than ten years later, just one in four men will see the return of their fertility.
To determine whether it will be successful, testing may be done to analyse whether there is sperm in the fluid in the vas. This may be carried out at the time of the procedure.
Treatment
Surgery
The only way to join up the vas again is through a surgical procedure. This can often be carried out as an outpatient case and can be done through two methods.
The first is a straightforward vasovasostomy and the surgeon will make two cuts to access the tubes. The two severed ends of the tube are sewn together again.
The second is called a vasoepididymostomy, and this involves the vas being attached to the epididymis, which is what holds the sperm in the testicle. This is more complicated and may have to be done if a vasovasostomy is not possible or unlikely to be successful.
The type of reversal will depend on whether sperm is seen in the fluid in the vas – if it is not present, then it is likely a vasoepididymostomy is required. It is unlikely that a man will know which method needs to be used until the operation is underway. It may also be that a combination of the two different methods is required on each side.
It can take up to a year for the sperm to return to the semen, but it can happen within a few weeks.
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