What is a vasectomy reversal?
About 3% of men who’ve had a vasectomy will think about having more children, for reasons such as a new relationship. If you’ve had a vasectomy and want to have children, you can either have a vasectomy reversal or use a form of assisted reproductive treatment (ART).
A vasectomy reversal involves re-joining the cut ends of the vas deferens, usually by microsurgery. The operation is much more complex than the original vasectomy and is generally done under general anaesthetic by a specialist. It can take several hours.
Find out more about vasectomy.
How successful is a vasectomy reversal?
In 80-90% of vasectomy reversals done by experts, sperm return to the ejaculate. The chance is lower if:
There has been a long time between the vasectomy and the reversal (after 10-15 years, the chances fall significantly)
A large amount of vas deferens was removed originally, or it was cut near the epididymis
Other blockages have developed in the epididymis.
Even after successful surgery, it’s not guaranteed that you’ll be able to get your partner pregnant. After vasectomy reversal, only about 40-70% of couples achieve a pregnancy over the next 2-3 years of regular sex. The chance of pregnancy is lower when the woman is older or has other fertility issues. Sperm problems might be an issue if you have a lower sperm count, poorer sperm function, if your epididymis has been damaged, or if you have sperm antibodies.
What are sperm antibodies?
Sperm antibodies happen when the immune system reacts to your own sperm as if it were foreign (unknown) tissue. About four in five men develop sperm antibodies after a vasectomy.
How is a vasectomy reversal affected by sperm antibodies?
In most men, sperm antibodies don’t cause any problems and will not affect the chance of a pregnancy, so testing for sperm antibodies isn’t needed before a vasectomy reversal.
However, in a few men, sperm antibodies can interfere with the ability of sperm to swim, attach to and penetrate the egg. This can stop fertilisation happening, even if the vas deferens is successfully re-joined.
When is assisted reproductive treatment (ART) used after a vasectomy reversal?
If you’ve had a vasectomy reversal but your partner is still unable to become pregnant, assisted reproductive treatment could help. Depending on individual circumstances, some couples decide not to have a vasectomy reversal and use assisted reproductive treatments straight away. Factors that can affect this choice include:
The time since your vasectomy
The age and fertility of the woman
How many children you want to have
The availability and cost of surgical and ART services.
What assisted reproductive treatments are available after a vasectomy reversal?
After a vasectomy reversal, intracytoplasmic sperm injection (ICSI) is a type of assisted reproductive treatment similar to IVF that could help.
Sperm are collected from the testicles using a fine needle under local anaesthetic. The sperm are then injected one by one into a woman’s eggs. Treatment success depends mainly on the age and health of the woman who provides the egg. For women in their 30s, typical pregnancy rates are around 40% per cycle.