Can vasectomies actually be reversed?

In a vasectomy, surgeons cut the "sperm superhighway" -- the vas deferens. See more surgery images.
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Women's choices for birth control are vast. They can choose from pills, patches, shots and IUDs, to name a few. But, aside from the condom, the vasectomy is the closest thing modern medicine has come to an effective male birth control option. Getting a vasectomy is like a woman receiving a lifetime supply of birth control pills -- without the side effects -- or having her tubes tied, which is a much more complicated procedure than a vasectomy.

A vasectomy is a simple procedure. Surgeons cut the vas deferens, which are the two tubes that transport sperm from the testicles to the penis. With these two quick slices, a man's semen is sperm-free, and he can enjoy permanent birth control.

Vasectomies are considered a permanent form of birth control, but some men do opt to reverse them. This is accomplished with a procedure known as a vasovasostomy. Vasovasostomies aren't new. In fact, they've been around for more than 100 years, with the first successful operation reported in 1919 [source: eMedicine]. In the United States, approximately 600,000 men have vasectomies every year, and 5 percent of those go back for a vasovasostomy [source: eMedicineHealth]. The reasons behind this change of heart vary, but it's commonly because of remarriage, the death of a child, or improvement in financial situation. Very rarely, doctors will perform a vasovasostomy to ease the pain from complications of a vasectomy.

­Reversal is definitely a tempting option, but it's not always successful. One effect of a vasectomy is that the body can actually cease to recognize its own sperm and can develop antibodies to it. If this has occurred, chances are low that a vasectomy reversal will enable a man to impregnate his partner. Another factor is how long someone waits to change his mind. Even if the vasovasostomy does result in a successful restoration of the "sperm superhighway," the chance of pregnancy is lower than it was before the vasectomy. For example, if a man opts for a vasovasostomy three years after a vasectomy, there's a 97 percent chance that his vas deferens will be successfully reopened. However, his chance of getting his partner pregnant is not so impressive -- only 76 percent. And that's the best-case scenario. The longer the span of time between the vasectomy and the reversal, the less chance that reversal will work. Someone who waits 15 years or more to reverse a vasectomy has about a 71 percent chance of rebuilding his vas deferens and a mere 30 percent chance of actually getting his partner pregnant [source: eMedicineHealth].

On the next page, we'll learn the details of the vasovasostomy procedure.­­­­

The Vasovasostomy Procedure

A vasectomy reversal is a tempting option, but it's not quite as easy as slapping on a Band-Aid.
A vasectomy reversal is a tempting option, but it's not quite as easy as slapping on a Band-Aid.
© istockphoto.com/cloki

Not surprisingly, "uncutting" the vas deferens is not as easy as cutting it. While a vasectomy takes about 20 minutes [source: Planned Parenthood], a reversal of the procedure can take anywhere from two to four hours [source: WebMD]. Neither procedure requires an overnight hospital stay, but with a simple vasectomy a man can be in and out of the doctor's office or hospital in about an hour or two. With a vasovasostomy, he should take the entire day off and expect to be in the hospital for at least six hours.

The procedure can take even longer if there is an obstruction of the epididymis, the "sperm storage facility" where sperm mature. This type of obstruction is common after a vasectomy. A vasovasostomy with obstruction removal is called a vasoepididymostomy, which can take about an hour longer than a vasovasostomy. Also, if this type of procedure needs to be done, the chances of sperm production drop considerably.

During a vasovasostomy, the surgeons will usually make an incision directly over the vasectomy scar, which is about 2 centimeters long. Once they locate the vas deferens on both sides, they recut it to create clean edges that are then sewn back together. The patient is then all stitched up and sent home after a few hours in recovery. Recovery takes approximately a month, with patients going back to work within three to seven days but refraining from sex for the full month.

Just as the reversal surgery is more complicated than the vasectomy, the price of both procedures differs greatly in price. A vasectomy can cost anywhere from $300 to $1,000, but is often covered by insurance [source: eMedicineHealth]. However, vasovasostomies can run anywhere from $4,000 to $13,000 and are rarely covered by insurance [source: Planned Parenthood].

To learn more about vasectomy reversal, take a look at the links on the next page.

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Sources

  • EMedicine: Reversing a Vasectomy. http://www.emedicinehealth.com/vasectomy/page7_em.htm
  • EMedicine: Vasovasostomy and Vasoepididymostomy. http://www.emedicine.com/med/topic3090.htm
  • Planned Parenthood: Vasectomy. http://www.plannedparenthood.org/birth-control-pregnancy/birth-control/vasectomy.htm
  • WebMD: Vasectomy reversal (vasovasostomy). http://www.webmd.com/infertility-and-reproduction/vasectomy-reversal-vasovasostomy
  • WebMD: A Second Chance: Vasectomy Reversals. http://men.webmd.com/news/20070613/a-second-chance-vasectomy-reversals