Vasectomy reversal success rates and results

The results from vasectomy reversal are exceptional with the restoration of sperm in 90% of men and successful pregnancy in the majority of couples. This is particularly so when the duration from vasectomy to reversal is less than 10 years and the age of your partner is less than 35 years.

Success from vasectomy reversal is measured in two ways. The first is the practical success of your operation: which means whether the surgery has led to the return of sperm. The second and most important is functional success which is whether pregnancy is achieved.

Practical success - Return of sperm

Sperm returns in approximately 90% of men who have a vasectomy reversal. The outcome is higher for those with a shorter time from vasectomy to reversal and less for those with longer duration. Even in men who had a vasectomy more than 20 years ago sperm are present in the majority after Vasectomy Reversal.

Sperm usually return gradually and in a progressive manner such that for the average man undergoing vasectomy reversal by 6 weeks after surgery approximately 50% of men will have sperm present; by 12 weeks to 90%.

Real success - Pregnancy Rates

For the average patient undergoing microsurgical vasectomy reversal the overall postoperative pregnancy rate is high at 50% to 80%.

Your personal probability of achieving a successful pregnancy after vasectomy reversal is dependent on two key factors:

  • The duration of time since vasectomy
  • Your partner’s age

The single most important factor influencing pregnancy rates and take home baby rates following vasectomy reversal is female age. The younger your partner the higher the chance of successful pregnancy.

The shorter the time since the vasectomy, the higher the chance of a successful reversal. This is due to back pressure effects on the testis causing damage to sperm production. In addition the very fine tubule (epididymis) just next to the testis is damaged by this pressure and can break open and then scar over so that there is a second blockage very close to the testis.

Health of babies following vasectomy reversal

Some doctors recommend waiting up to six months following vasectomy reversal before attempting achieve pregnancy. Their reasoning for making this recommendation is a fear that there may be an increased risk of having a baby with congenital abnormality. The basis of this fear stems from a study undertaken in the 1990's which was designed to determine is there was an increase proportion of sperm with extra or missing chromosomes in the semen of men following vasectomy reversal.

However, (1) the study was very small with less than 50 men enrolled (2) no subsequent study has repeated the findings, (3) there are no studies which demonstrate an increase risk of abnormal babies in men following vasectomy reversal once the results are adjusted for female age [which is by far the most important risk factor] and (5) studies into couples undertaking IVF where man has had a prior vasectomy which has not been reversed similarly do not show an increased risk of producing babies with congential abnormality.

I do not recommend that you wait to conceive but of course that is up to you.

Predictors of successful vasectomy reversal

The are a range of other influences on and predictors of successful vasectomy reversal including the type of vasectomy, post vasectomy testicular damage and in particular, prior IVF sperm extraction procedures.

Choice of surgeon - Why experience matters

Of all the things that you can control to maximise the chance of successful vasectomy reversal the most important is your choice of doctor. As there is a wide range of experience and expertise in doctors performing vasectomy reversal in Australia, the number of operations a surgeon performs is an major influence on success rates. The majority of surgeons perform less that 10 vasectomy reversals per year so choosing a specialist reproductive microsurgeon who performs large numbers of vasectomy reversal operations is important.

My entire clinical focus is fertility and fertility microsurgery.

Detailed information on vasectomy reversal

For those who want to research the fine detail about vasectomy reversal, my colleague Dr Woolcott has written an excellent article for the 'Australian Doctor' journal, which is supplied to all General Practitioners in the country. In it you can read all of the information we provide to doctors who refer patients to us for vasectomy reversal.

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Dr Gabrielle Dezarnaulds - Vasectomy Reversal Australia