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Vasectomy Reversal Frequently Asked Questions

Frequently Asked Questions and Answers About Vasectomy Reversal

Q. Is it possible to reverse a vasectomy after 10 years?
A. Yes. Contrary to popularly beliefs, the chance of a successful reversal after 10 years post-vasectomy doesn’t decrease. Dr. Bastuba has successfully reversed patients up to 40 years following vasectomy with pregnancy occurring as early as a few months. However, chances are higher when performed by an experienced infertility microsurgeon like Dr. Bastuba. Watch vasectomy reversal patients tell their success story on TV (this link will take you to our main site).

Q. With ICSI only a handful of sperm are needed, why should I have a vasectomy reversal?
A. Both vasectomy reversal and ICSI/sperm aspiration are good alternatives to father a child after vasectomy. They each have advantages and drawbacks. In most situations vasectomy reversal offers the most desirable option for pregnancy. It requires one procedure be performed only on the man and couples can then try to get pregnant every month the old fashioned way in bed at home. ICSI on the other hand requires that both partners undergo a procedure and the woman is stimulated with fertility drugs to treat a "male problem". Studies have shown the costs of establishing a pregnancy in this fashion are three times greater with ICSI than with vasectomy reversal alone. Studies have shown that it is even less expensive to have a failed vasectomy reversal with a redo vasectomy reversal than to have sperm retrieval with ICSI.

Q. For what reasons would I decide to have a sperm retrieval with ICSI instead?
A. The advantage of ICSI is the possibility for some couples to establish a pregnancy quicker than with vasectomy reversal. We recommend ICSI/sperm harvesting in those situations where vasectomy reversal would be difficult or impossible, the female partner is of advanced reproductive age, or when there is also a female factor contributing to the infertility. Each couples' circumstances are unique and need to be addressed on an individual basis. Our goal is to assist couples in having a child of their own, regardless of the path they choose. Read also our information on alternatives to vasectomy reversal.

Q. Do men stop making sperm 10 years after a vasectomy?
A. No. Unbelievably, good physicians still tell patients this. A man never stops producing sperm whether he had a vasectomy or not. Things that would stop a man from making sperm would be major insults such as exposure to high dose radiation, high dose radioactivity or extensive chemo therapy.

Q. Can any urologist perform a good vasectomy reversal?
A. It is impossible to perform a good vasectomy reversal without extensive training and special experience in microsurgery, especially reconstructive procedures such as vasoepididymostomy (VE). A physician should perform 20 to 100 vasectomy reversals a year to maintain expert proficiency. Most general urologists perform 0 to 2 vasectomy reversals a year. Though they consider themselves qualified, one must ask themselves have they been able to maintain their proficiency in this extremely technical task. Dr. Bastuba is one of the 2% urologists in the US who have had the specialized microsurgical training and maintained these high case loads to make sure that their technical skills are at their utmost. If you are deciding on a male fertility specialist, make sure you ask questions about how many vasectomy reversals he performs, about his expertise and specialty. A good idea is to ask to speak with some of his patients that have already undergone the procedure. It also is helpful to check his medical background including possible malpractice records. For Dr. Bastuba, these demanding procedures are routine in his daily practice. (Read our tips on how to find a good vasectomy reversal doctor)

Q. How soon after my reversal will I have sperm in my semen?
A. The return of sperm after vasectomy reversal may be immediate or may take up to 12 months. The difference lies in the type of the procedure required and the intra-operative findings. If there are high numbers of very motile (swimming) sperm at time of the vasectomy reversal and vasovasostomy alone is required than it is common for sperm to be present at the initial semen analysis at one or two months post-op. If vasoepididymostomy is required on both sides than it can take six to 12 months or even longer for the return of sperm to the ejaculate. However, when sperm does return to the ejaculate, it has not been shown that the length of time is important as to the end result. This means that good results still occur even if there is a significant delay for the return of sperm to the ejaculate. For some couples, this is an important factor to consider and one of the reasons why in females of advanced age, sperm retrieval versus vasectomy reversal may make sense or if the couple is in extreme hurry to get their family started. Following the return of sperm to the semen, Dr. Bastuba recommends early consideration of freezing of sperm to lock in a good result. It is also important to check sperm counts at intervals post-op to make sure that late scarring and blocking of the tube has not occurred.

Q. Is it worth to try another vasectomy reversal if the first one was unsuccessful?
A. In most cases, failed reversals are due to technical mistakes by the surgeon. A second attempt for a vasectomy reversal is still less expensive and the most effective choice for a couple to have a child. Since each case is different, specialists like Dr. Bastuba can evaluate your situation and offer you a solution. (Read our information about failed vasectomy reversals)

Q. What will my recovery from reversal surgery be like?
A. Since the procedure is done in an outpatient setting, the recovery time after the local anesthesia is short. Some patients compare post-op recovery similar to recovery after their vasectomy. Most of the discomfort or pain can easily be controlled with medication such as Advil or Aleve. We will also give you a prescription of stronger medication just in case. Please make sure that a familiy member or friend will care for you in the first 24 hours after surgery. Read  more information about patient care after the vasectomy reversal.

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