Vasectomy Reversal: How Men Can Successfully Restore Their Fertility

Author photo
Zappelphilipp Marx•
Microsurgical vasovasostomy under the operating microscope

A vasectomy need not be the end of your family plans. Thanks to modern microsurgical techniques, the vas deferens can often be reconnected and natural conception restored.

Are You a Suitable Candidate?

  • Vasectomy performed less than 10 years ago
  • No significant scarring or infection in the scrotum
  • Good overall health (BMI < 30)
  • Partner with normal ovarian reserve, ideally under 35 years

Why Men Consider Reversal

  • New relationship: desire for a biological child together
  • Changed life plans: financial stability and room for family
  • Family loss: bereavement or wish for siblings
  • Regret: vasectomy done under stress or illness

Surgical Procedures Overview

Vasovasostomy

The standard technique uses high-powered microscopy to suture the two ends of the vas in two layers. A PMC clinical review reports patency rates of 90–95 % and pregnancy rates up to 76 %.
Source: PMC Clinical Update 2016

Vasoepididymostomy

This is used if the epididymis is blocked or the vasectomy is over ten years old. The vas is connected directly to an epididymal tubule—technically demanding but sometimes the only option.

Success Rates & Influencing Factors

A meta-analysis of 8 324 patients reports a patency rate of 94 % and cumulative pregnancy rates of 60 %.
Source: PubMed 2022

  • Time since vasectomy: shorter intervals yield better outcomes
  • Sperm seen in fluid test: a positive prognostic sign
  • Partner’s age & egg quality
  • Surgeon experience: ≥ 50 reversals per year

Pre-operative Assessment

  1. Physical examination & medical history with a urologist
  2. Optional hormone panel (FSH, testosterone) if over 40
  3. Scrotal ultrasound to exclude scarring
  4. Detailed consent discussion on risks, success likelihood and costs

How the Operation Works

Under general or spinal anaesthesia, the surgeon makes a ~2 cm incision on each side, exposes the vas deferens and checks the fluid for sperm. Then:

  • Vasovasostomy: two-layer 9-0 suture of mucosal and muscular layers
  • Vasoepididymostomy: attach to epididymal tubule if no sperm are present
  • Many centres now use robotic assistance to halve suture time and enhance precision.
    More info: Vasectomy Reversal – Wikipedia

Experienced centres complete each side in about two hours.

Aftercare & Recovery

  • 24-hour rest with scrotal cooling
  • Supportive underwear or jockstrap for one week
  • No heavy lifting or strenuous exercise for 14 days
  • No intercourse for 10 days, then gradual resumption
  • First semen analysis at six weeks, then periodically until stable

Fertility-Boosting Tips

  • Three-month smoking cessation
  • Limit alcohol to one drink per day
  • Diet rich in zinc, selenium and omega-3s
  • 150 minutes of moderate exercise per week

Costs & Funding

In the UK, reversal typically costs between £2,500–£5,000. The NHS rarely covers vasectomy reversal, though some private medical insurers may contribute. A single reversal can be more cost-effective than multiple IVF/ICSI cycles.

Alternatives if Reversal Fails

  • TESA/MESA: sperm retrieval directly from testicle or epididymis
  • IVF/ICSI: laboratory fertilisation even with low sperm counts
  • Cryopreservation: freeze retrieved sperm for later use

At-Home Insemination via RattleStork

RattleStork connects intended parents with verified donors. Individuals and couples can plan home insemination safely, swiftly and affordably.

RattleStork – the sperm donation app
Illustration: RattleStork – the sperm donation app

High-Tech Outlook

Research centres are developing nano-coated vas stents to prevent scar closure, and exploring bio-glue anastomosis—a hydrogel sealant achieving 99 % patency in animal models. A 4K robotic microsurgery pilot is due in 2027.

Conclusion

For vasectomies under ten years old, reversals can achieve patency rates up to 95 % and pregnancy rates up to 60 % when done by experienced microsurgeons—often the most cost-effective option before IVF or ICSI.

Disclaimer: Content on RattleStork is provided for general informational and educational purposes only. It does not constitute medical, legal, or other professional advice; no specific outcome is guaranteed. Use of this information is at your own risk. See our full Disclaimer.

Frequently Asked Questions (FAQ)

A vasectomy reversal reconnects the divided ends of the vas deferens microsurgically to restore natural sperm passage and fertility.

Patency rates are 90–95 % with cumulative pregnancy rates of 50–60 %, depending on time since vasectomy and partner age.

It’s used if no sperm are found in vas fluid or if the vasectomy was over ten years ago.

Under general or spinal anaesthesia, a small scrotal incision is made, the vas ends are exposed and sutured under microscope—procedure lasts 2–4 hours.

Common complications include bruising, infection or temporary swelling; serious risks are very rare.

Recommended: 24-hour rest, scrotal cooling, supportive underwear for a week, and a semen analysis at six weeks.

Generally avoid intercourse for 10 days, then resume gently.

Sperm may return as early as six weeks; stable counts usually by 3–6 months.

Men under 45 and partners with good egg reserve have higher success rates.

Costs range from £2,500 to £5,000; NHS coverage is rare, though some private insurers may contribute.

Alternatives include TESA/MESA sperm retrieval, IVF/ICSI in lab, and cryopreservation of retrieved sperm.

Shorter time since vasectomy, positive intra-operative sperm, experienced surgeon and good partner fertility all boost patency.

Seek high-volume centres (≥50 reversals/year) with published outcome data.

Yes, but success decreases and scarring risks rise with each attempt.

Many couples conceive within 12 months of confirmed patency, often in the first six months.