Frequently Asked Questions
Who Does Vasectomy Reversals?
Vasectomy reversals are most often done by urologists, but not all urologists do this type of surgery often. You should ask your urologist how many he/she has done, and to what level of success. If your urologist thinks you should have microsurgery, you should ask about his/her track record. This technique calls for extra training and expertise.
Can All Vasectomies be Reversed?
Almost all vasectomies can be reversed. But if the vasectomy was done while fixing a hernia in the groin it may not be as easy to join the ends of the vas. The ends also may not be able to be joined if a very long piece was removed during the vasectomy, but this is rare.
Should I Have a Vasovasostomy or a Vasoepididymostomy?
You can't tell before the reversal which method is best for you. Your urologist can only find this out during the surgery. If sperm are found in the vasal fluid, then a vasovasostomy is done. If there are no sperm in the fluid, your urologist will decide what to do based on other factors. If there's a block in the epididymal tube, then a vasoepididymostomy will be needed.
If no block is found, then the way the vasal fluid looks may help your urologist decide which method is best. For the most part, if the fluid looks watery, he/she will tend to do a vasovasostomy even if no sperm are found in the fluid. Fluid that looks creamy without sperm suggests that vasoepididymostomy is needed. Some patients may need a vasovasostomy on one side and a vasoepididymostomy on the other.
Is Age a Factor in Conceiving after a Vasectomy Reversal?
Your age shouldn't affect the results of your vasectomy reversal. Most men keep making sperm for many years after their partners stop making eggs. Women become less fertile starting in their mid-30s, with a major drop around age 37. Your partner should check with her gynecologist to see if she is still ovulating before you agree to a reversal.
Are There Alternatives to Vasectomy Reversal?
There are other ways to get your partner pregnant without a reversal. Your urologist can take sperm from your testis or epididymis using a needle or by surgery ("sperm retrieval"). But sperm taken this way can't be used in basic, low-cost office artificial inseminations. Instead, these sperm need more complex, costly ($12,000 to $17,000) in vitro fertilization (IVF) techniques using intracytoplasmic sperm injection (ICSI).
Most centers have about 4 out of 10 pregnancy rate with IVF/ICSI if the female partner is younger than 37. The pregnancy rates are much lower if she is older. Studies show that reversals are more cost-effective in reaching pregnancy than sperm retrieval and IVF/ICSI. Another plus of reversal over sperm retrieval/IVF is the chance for future pregnancies.
Your choice may be influenced by which methods your health plan covers. You might also weigh cost, years since vasectomy (and the chance of needing an epididymovasostomy), and your partner's age.
If a Vasectomy Reversal Fails, Should I Try it Again?
When done by skilled microsurgeons, success rates for repeat reversals are often the same as for first reversals. Your urologist will review the record of your prior surgery to help you decide. If sperm were found in the vasal fluid then, he/she will likely do a repeat vasovasostomy, which is more likely to succeed.
How Much Does a Vasectomy Reversal Cost?
The cost of a reversal ranges between about $5,000 and $15,000 (plus other fees). Most health plans don't pay for reversals. You should talk with your health plan early in the planning to find out what they will cover.
Will a Vasectomy Reversal Cure Testis Pain from My Vasectomy?
Very few men get pain in the testis after a vasectomy that's bad enough for them to ask about reversal. Because these cases are rare, there aren't many studies of groups of these men. These studies suggest that it works for most men. Still, your urologist can't tell beforehand if a reversal will cure your pain.