Are vasectomies reversible? What you need to know if you change your mind

• While a vasectomy is considered a permanent form of birth control, it is possible to undo the prodecure through a vasectomy reversal.
• Based on previous research, the average pregnancy success rate after a vasectomy reversal is only 49%.
• The sooner a vasectomy is reversed, the better the chances of a successful pregnancy.

Vasectomies are the second most common form of permanent contraception in the US. And, while they may be reversible, only 6% of people who have had vasectomies request a reversal, says Elmer B. Pineda, MD, a urologist with Pomona Valley Hospital Medical Center.

It's also important to note that getting a vasectomy reversal doesn't ensure a successful pregnancy.

If you're considering a vasectomy reversal in order to have a child, it's important to know the odds as well as risks associated with the procedure.

What is a vasectomy reversal?

When someone undergoes a vasectomy, their vas deferens - or the tubes that carry sperm from the testicle to the penis - are severed or cut off. Therefore, a vasectomy reversal is a surgical procedure that re-connects these tubes, thereby restoring fertility.

However, a 2018 review found that while the average rate of patency, or the presence of sperm in the semen, after vasectomy reversal was 87%, the average rate of pregnancy was only 49%.

"Even when a patient has a successful return of sperm to semen, they may not be able to achieve pregnancy," Yih says. "There are a lot of other factors that go into achieving pregnancy, which is why the number is lower."

Other factors that can affect pregnancy rates after vasectomy reversal include:

• Age of the partner trying to get pregnant
• Surgeon experience and training
• Past fertility problems prior to getting a vasectomy

While you can reverse a vasectomy at any time, success is greater the sooner you do so. For example, pregnancy success rates can be as high as 76% if the reversal is done within 3 years of the vasectomy, but drop to about 30% after 15 years or more, says Jessica Yih, MD, a urologist with The Ohio State University Wexner Medical Center.

That's because the longer you wait to get a reversal, the more likely you are to develop blockages that prevent the sperm from coming out of the vas deferens.

What's the cost? Vasectomy reversals are usually not covered by insurance, Pineda says. The cost of the procedure can range from $5,000 to $15,000 depending on where you live and the rates your doctor's medical practice charges.

How do vasectomy reversals work?

A vasectomy reversal is done under general anesthesia and takes about two to four hours, Pineda says. There are two procedures to reverse a vasectomy:

• Vasovasostomy, which connects the two ends of the tube carrying sperm back together.
• Vasoepididymostomy, which is a more complex procedure where the vas deferens are connected to a much smaller tube in the duct behind the testis, called the epididymis.

Doctors will decide which procedure to perform after making two incisions on each side of the scrotum and extracting fluid from the testicle side of the vas deferens, Yih says. If the fluid contains sperm, they will perform a vasovasostomy. If it doesn't, then they will perform a vasoepididymostomy.

Follow-up protocol after a reversal differs slightly among urologists, Pineda says, but in general, your doctor will test your semen every 2 to 3 months to determine sperm count. And patience is key here, since it may take 4 to 12 months for your partner to become pregnant after a vasectomy reversal.

Vasectomy reversal recovery

Full recovery after a vasectomy reversal can take one to two weeks, Pineda says, and the pain is likely to be more intense than your vasectomy recovery, but still relatively mild overall.

According to Pineda, after the procedure you may experience:

• Mild scrotal discomfort
• Bruising and swelling of the scrotum
• Bleeding
• Infection, though the risk is low - less than 3%

Patients are usually advised to wear scrotal support, like a jockstrap, for about a month afterward, avoid strenuous activity, and do not lift anything heavier than 5 to 10 pounds for about four weeks, Pineda says.

Yih recommended patients not ejaculate for a full month after their surgery. Ejaculation can stress the recently reconnected tubes and increase the risk of failure from scar tissue blocking off the connection.

Insider's takeaway

While a vasectomy is meant to be a permanent form of contraception, it is possible to reverse it through surgery to become fertile again.

However, it is not a foolproof procedure. In fact, pregnancy success rates after a vasectomy reversal are usually about 49%. Yet, the odds are more favorable the closer it is to the time of the vasectomy.

Therefore, if you are considering a vasectomy reversal, the sooner you do it the better the outcome.