A successful vasectomy reversal will allow sperm to again be present in the semen, thus allowing fertilization of a woman’s egg. Vasectomy reversal works for most men, but not for some.
Men decide to have vasectomy reversals for a number of reasons, including loss of a child, remarriage, or improved finances making it feasible to raise a child. A vasectomy reversal may also treat testicular pain that may be linked to vasectomy.
The success of vasectomy reversal is related to the passage of time since the original vasectomy—the longer it’s been, the less likely it is to work.
Vasectomy reversal is done under anesthesia usually by a urologist. Once a man has decided to reverse a past vasectomy, consulting a urologist or surgeon who will conduct the surgery will make him aware of the many risks and complications and of the important pre- and post-surgery preparations. Doctors usually perform vasectomy reversals at a surgery center or at a hospital. The procedure is generally done on an outpatient basis — without an overnight stay.
About six weeks after surgery, the surgeon will examine the man’s semen under a microscope to see if the operation was successful. When a vasectomy reversal is successful, sperm usually appear in the semen after a few months, but it can sometimes take a year or more. Vasectomy reversal leads to pregnancy in about half of couples within two years.
A man may instruct the surgeon ahead of time to capture and freeze any sperm that is found during the surgery in case vasectomy reversal doesn’t work. This type of frozen storage is called cryopreservation, and the sperm may be used later during in vitro fertilization (IVF) if the man is unable to father a child through sexual intercourse.
Vasectomy reversals sometimes fail if there is a sperm blockage that wasn’t recognized during surgery, or if a blockage develops sometime after surgery. Some men have a second-attempt vasectomy reversal surgery if the procedure doesn’t work the first time.
A man may also be able to father a child by using frozen sperm retrieved during the vasectomy reversal through in vitro fertilization. If a man didn’t have sperm frozen, IVF may still be possible using sperm retrieved in one of several techniques done by reproductive specialists.
Since the advent and success of ICSI (intracytoplasmic sperm injection, or fertilization of a mature egg with one sperm), many couples would rather undergo IVF with ICSI following TESE (testicular sperm extraction) than submit the male partner to a vasectomy reversal. The results are excellent and in the end help the couple to achieve conception at a lower cost.