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 the Male Urology 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 become a dad.

Essentially, a vasectomy reversal undoes the vasectomy surgery.

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

During a vasovasostomy vasectomy reversal procedure, the surgeon reconnects the two ends of the vas deferens that were severed during the original vasectomy procedure. This allows sperm to travel to the urethra, which carries sperm through the penis, where it can be ejaculated. This may make it possible for the man to get a woman pregnant again.

The surgeon makes a tiny opening in the scrotum to gain access to the two ends of the vas deferens that were separated during the vasectomy. Before performing the procedure, the surgeon collects fluid from the part of the vas deferens that is connected to the epididymis, where sperm matures and is stored. (One epididymis is attached to each testicle.)

• If sperm is present in the fluid, the surgeon performs a vasovasostomy procedure, reconnecting the two ends of the vas deferens.
• If no sperm is detected, there may be a blockage in the portion of the vas deferens that is connected to the epididymis, preventing sperm transport. In such cases, the surgeon may perform a more complex vasectomy reversal procedure called a vasoepididymostomy. In this procedure, the end of the vas deferens that is not connected to the epididymis is surgically connected to it.

These procedures enable sperm to move from the epididymis into and through the vas deferens.

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.

Doctors may instruct patients to ice the scrotum intermittently for the first two to three days following the surgery. Patients may also be advised to stay off their feet during this period. For the first two weeks after the procedure, patients shouldn’t stand or squat for long periods and should avoid lifting heavy objects. Wearing an athletic supporter or bicycle shorts may improve comfort during the first two weeks of recovery.

Men should avoid ejaculating and should not have sex for two weeks after a vasectomy reversal procedure. Most men are able to return to work 10 to 14 days after the surgery.

Patients may also need to take antibiotics and, in some cases, anti-inflammatory medications after the procedure. Pain medications can be used to manage pain or discomfort. If you stopped taking a medication for the procedure, your doctor will tell you when you can resume taking it.

“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.

“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 multiple treatment options to restore fertility after vasectomy, including microsurgical vasectomy reversal or sperm retrieval and in vitro fertilization, if needed.