Vasectomies can be reversed even after very long periods of time. After vasectomy, sperm continue to be produced in the testicles, even though they are trapped inside, and so, even after many years, reversal is still likely a viable option. However, the success of the procedure is dependent upon the experience of the surgeon, the technique that is used, the health of the patient and the length of time since the vasectomy.
Although different practitioners may do things differently, in my hands vasectomy reversal is performed as an outpatient surgery and is performed with the patient asleep under anesthesia. It typically takes approximately 3 to 4 hours using an operating microscope to perform the surgery. The patient is recommended to wear a scrotal support for 2 weeks and to avoid heavy lifting and sexual intercourse during the first 2 weeks after this surgery.
Whether or not it is covered by insurance, is variable, and dependent upon the patient’s individual insurance policy.
There are patients who, for a variety of reasons may, over time have lost their ability to make sperm or at least produce sperm at a substantial level. A number of medical factors can cause this loss of capacity in sperm production. Each of my patients undergoes an initial evaluation prior to reversal in order to counsel patients appropriately about their chances of success.
Another other option to initiate a pregnancy would be a surgical sperm retrieval procedure in conjunction with an in-vitro fertilization using that retrieved sperm to inseminate the partners eggs. This is often an alternative for patients unable to have a reversal.
Initially, patients commonly experience some swelling, pain and or bruising; however, after this heals, there are no common long-term issues.
Success rates defined as having sperm in the ejaculate within the first year after the procedure are listed below. Infrequently, the connection ‘closes down’ resulting in no sperm being present in the ejaculate. It is for this potential and for the minority of patients that do not have success that I recommend banking sperm obtained during the surgical procedure and after sperm is found in the ejaculate. Although I recommend this to everyone, typically half of my patients avail themselves of this option.
Bilateral Vasovasostomy: 95%
Unilateral vasovasostomy: (Sperm seen prior to anastomosis) 90%
Vasovasostomy (Sperm not seen prior to anastomosis) 85%