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Overview

Sometimes life changes. Some men who have had a vasectomy decide they now want to grow their family—or start a new one. Vasectomy reversal (the medical term is vasovasostomy) is a procedure that can help you father children again or for the first time.

This is true even if your vasectomy was done many years ago. “A common misperception is that if you are more than 10 years out from your vasectomy a reversal won’t work,” says Stanton Honig, MD, director of Yale Medicine Urology’s Male Reproductive Health Program. Dr. Honig has more than 20 years’ experience with microsurgery and vasectomy reversals. “There’s a high success rate, even when many years have passed,” he says.

At Yale Medicine, our surgeons offer a range of vasectomy reversal options, giving you the best odds for success if you want to be a dad.

What is a vasectomy reversal?

Essentially, a vasectomy reversal undoes the vasectomy surgery.

To perform a vasectomy, the surgeon makes a small incision in the scrotum and cuts the vas deferens (the tube that carries sperm to the semen). The two ends then get cauterized and stitched, blocking the pathway of sperm.

During a vasectomy reversal, the surgeon reconnects the two ends of the vas deferens which were severed during the original vasectomy procedure. This allows sperm to enter semen yet again, making pregnancy possible.

How is a vasectomy reversal performed?

The surgeon makes a tiny opening in the scrotum to gain access to the two ends of the separated vas deferens. Before reconnecting the ends surgically, the surgeon checks the fluid that comes from each tube. If sperm is present, the tubes are micro-surgically reconnected. If no sperm is detected, the surgeon will need to decide if it is better to attempt a more complex reconstruction from the epididymis to the vas (called an epididymovasostomy). This is a key reason why it is important to see a surgeon with extensive microsurgical experience.

How long does vasectomy reversal take?

Because vasectomy reversal is more complicated and technically challenging than vasectomy itself, the surgery takes longer than a vasectomy (a 15-minute procedure) and needs the skill of a microsurgeon. Vasectomy reversal, which can be performed as an outpatient procedure under general anesthesia, can take up to three or four hours. Sometimes vasectomy reversal is even covered by insurance.

How long does it take to recover from a vasectomy reversal?

It really depends on the patient, but in general patients are up and around after surgery. Men are typically able to perform most non-strenuous activities after 24 to 48 hours. Due to the complex nature of the procedure, men usually return to work after a week. You should not have sex for two to four weeks after surgery. 

Following vasectomy reversal, a man will experience some discomfort which can be managed with Ibuprofen or pain medication and by applying an ice pack to the testicles when needed. Most patients do not require significant pain medication after 48 hours.

How effective is vasectomy reversal?

“The success rates are very good—80 to 90 percent when performed by an experienced microsurgeon—that you will have sperm coming out after vasectomy reversal,” says Dr. Honig. This does not guarantee pregnancy, but many couples do conceive naturally after vasectomy reversal.

What makes Yale Medicine unique?

Vasectomy reversal is a technically challenging procedure, so patients benefit from working with a surgeon who has performed it many times already. “I’ve been helping patients this way for over 20 years,” says Dr. Honig. “A vasectomy—even one performed 15 or 20 years ago—doesn’t have to mean that you can’t reconsider the joys of fatherhood.” 

Yale Medicine offers all treatment options to restore fertility after vasectomy, including microsurgical vasectomy reversal or sperm retrieval and in vitro fertilization, if needed. We do all we can to make paternity possible for men who’ve previously had a vasectomy.