Are Vasectomies Actually Reversible? Doctors Explain.


Are Vasectomies Actually Reversible? Doctors Explain.

YOU GOT A vasectomy a few years ago when you were fully committed to a child-free life, or you were certain you were ready to not bring more kids into the world than you already have. But now you're not so sure. So, can your vasectomy be reversed? There's no guarantee.

"Men should understand that even though, yes, a vasectomy is reversible, it should be considered permanent," says Marc Goldstein, M.D., a urologist at Weill Cornell Medicine and NewYork-Presbyterian, who specializes in male reproductive medicine and microsurgery and has been performing vasectomies for over 40 years.

"Don't do a vasectomy if you're planning on having it reversed," he says. The reversal procedure is also much more complicated than the procedure itself. It's costly, and the results aren't always guaranteed, meaning conceiving a child afterward can be a struggle.

If you're considering a vasectomy with the idea of maybe getting it reversed later, here's what doctors want you to know.

VASECTOMIES ARE COMMON and low-risk, says Alexander Epelbaum, M.D., a urologist and partner physician at Advanced Urology Centers of New York. "It's probably one of the most common urologic procedures that we do."

It's a surgical procedure for men that involves cutting and blocking the vas deferens, or the tubes that carry sperm out of the testes to reach your semen, according to Johns Hopkins Medicine. While you can still ejaculate normally after a vasectomy, your semen will no longer contain sperm, so it's effective in preventing pregnancy.

A vasectomy is much safer and more effective than a tubal ligation (a.k.a., getting your tubes tied) for women, Dr. Goldstein says. The procedure is typically outpatient, done under local anesthetic, and only takes about 15 minutes, Dr. Epelbaum says. Sometimes patients prefer to be sedated, but it's rare.

You can usually go home right after, and most people just experience mild tenderness in the area for a day or two, says Mahyar Kashani, M.D., director of male sexual health and assistant professor of urology at Mount Sinai South Nassau Hospital. He suggests icing the area to reduce swelling and taking an over-the-counter pain reliever if you need it -- and avoiding strenuous activity (including sex) for about a week.

Another important thing to note: you're not immediately sterile after a vasectomy, Dr. Epelbaum says. Sperm can linger in the vas deferens, and it can take about 15 ejaculations to clear it out (or a couple of months). He urges patients to get a semen analysis after two or three months to make sure it's sperm-free.

IF YOU DECIDE that you do want to have children later on, vasectomies are reversible, but "reversals are a much bigger procedure" than the vasectomy itself, Dr. Goldstein says.

"A vasectomy reversal is pretty straightforward in terms of the theory but can be a little challenging," Dr. Kashani says. Reversals require a "high-powered operating microscope," Dr. Goldstein explains. Essentially, doctors need to realign the ends of your vas deferens that were cut and put everything back together. Not all doctors have the technical skills to perform successful reversals.

A vasectomy reversal is done under general anesthesia, and it "can take a few hours as opposed to a few minutes to do the vasectomy," Dr. Kashani says. They're also pricey and not typically covered by insurance, he adds.

"If you do a vasectomy and then you want to have it reversed, there's a lot of time that will go into it, and a lot of money will also go into it," Dr. Kashani says. "It's an option, but you should never walk into [a vasectomy] thinking that it's so easy to just reverse it."

CONCEPTION AFTER vasectomy reversal might be a struggle, Dr. Epelbaum explains. Pregnancy rates after a vasectomy reversal range from 30 percent to 90 percent, according to the Mayo Clinic. Even so, Dr. Goldstein says it can sometimes take time for your partner to get pregnant.

"Typically, it takes several years after a reversal for the sperm quality to be good enough for the partner to get pregnant naturally," he explains.

The longer you wait between the vasectomy and reversal can affect how much sperm you have in your semen, which can influence pregnancy rates, too, Dr. Kashani says. "After a reversal, you may have sperm in your ejaculate, but you may not be able to necessarily get someone pregnant."

Still, if you're interested in fertility, you have a couple of options instead of a reversal. For in-vitro fertilization, for instance, the sperm can be retrieved directly from the testicles, Dr. Epelbaum says.

Another option is to freeze your sperm in a sperm bank before having a vasectomy. Dr. Goldstein recommends freezing two or three specimens.

"That's a smart thing to do if you have even the slightest thought about possibly wanting children in the future," he says. "It'll obviate the need for having to go through the reversal procedure."

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