How to Get Pregnant After a Vasectomy

By CNY Fertility Updated on
How to Get Pregnant After a Vasectomy

When finished building their families, 1 in 20 married men choose to have a vasectomy as a relatively inexpensive and dependable form of birth control. But as they say, life happens, and sometimes plans change. When a couple who’s had a vasectomy decides they’d like more children and wonder how to get pregnant after a vasectomy, there are a few main topics and treatments to consider. Let’s get started!

Can a Vasectomies be Reversed?

Simply put, yes, a vasectomy is reversible via a vasectomy reversal surgery. During a vasectomy, the tubes within the scrotal sac that carry sperm from the testicles to the penis are surgically severed and sealed off (either burned, removed, or clipped) so that sperm can no longer mix with semen and be ejaculated. A reversal restores the connection and allows sperm to once again enter the semen.  Vasectomy reversal success rates depend on several patient-specific factors, but providing that the vas deferens was not destroyed during the initial vasectomy, 60-70% of men can expect to have a successful reversal.

There are two types of vasectomy reversals:  a vasovasostomy (VV) and a vasoepididymostomy (VE).  In order to determine which procedure is necessary, your surgeon will take and examine a sample of fluid from the end of the vas deferens to confirm the presence of sperm. If sperm are present, it’s evidence that there is no blockage in the epididymis, the surgeon will proceed with a slightly less complicated vasovasostomy during which the two ends of the vas deferens are reconnected. If no sperm are present, there may be a blockage in the epididymis where the sperm are stored. This requires the more complex technique of connecting the epididymis to the vas deferens through a vasoepididymostomy.

Getting Pregnant with a Vasectomy Reversal

Although success rates for both procedures vary slightly–50 to 70 percent of men are able to have a child after a vasovasostomy (VV), while men who undergo a VE have lower success rates of 20 to 40 percent– both procedures can allow a man to conceive with a partner through natural intercourse. Recovery usually takes a couple of days with minimal pain, limited physical activity, and no sexual activity for several weeks.

Sperm Levels After Reversal

After a vasectomy reversal, a man will see his physician every few months for a sperm analysis. After a VV, sperm count and motility can be normal within several months. After a VE, it can take anywhere from a few months up to a year for sperm counts to return to normal levels.

Research also indicates that men who have reversals performed 10 or more years after the initial vasectomy are more likely to have anti-sperm antibodies present. Anti-sperm antibodies are found in between 8% and 21% of men in the general population, 9% and 36% of infertile patients, and 70-100% of men after vasectomy.  The development of anti-sperm antibodies after a vasectomy is thought to be related to the breakdown of the blood-testis barrier and leakage of sperm antigens from the epididymis. Ultimately the antibodies prevent normal sperm function and reduce the chances of conception.

Results after a vasectomy reversal are not always instantaneous. It may take several months to see sperm in the ejaculate, and in some cases, progressive scarring can close off the vas deferens once again.  It can also happen that even though the reversal was deemed a surgical success, the number of sperm found in ejaculate can be lower than before any surgeries.

IVF + Sperm Extraction: How to Get Pregnant After a Vasectomy Without a Reversal

Newer surgical techniques now offer additional fertility options to men and their partners.  Sperm extraction procedures like
Percutaneous Epididymal Sperm Aspiration (PESA), Testicular Sperm Aspiration (TESA), and Testicular Sperm Extraction (TESE) are surgical sperm retrievals that can be used in conjunction with In Vitro Fertilization (IVF) to find and extract sperm from a male partner who does not have sperm in his semen/ejaculate. Even when a man has a vasectomy or a blockage, he still continues to produce sperm in his testes. Often men diagnosed with azoospermia (no sperm) suffer not from a failure to produce sperm, but rather a blockage or obstruction of the epididymis or vas deferens. By surgically aspirating sperm from the testes prior to the blockage, a fertility doctor is able to extract healthy sperm which can then be used to fertilize an egg. With procedures like Intra-Cytoplasmic Sperm Injection (ICSI), only a very few healthy sperm are actually needed.IVF

Vasectomy Reversal vs. IVF: Comparing your Options

Providing that both are options, there are certain pros and cons to each approach:

  • With a vasectomy reversal, a man will be fertile for years to come, but with sperm aspiration, he is only able to conceive for that one cycle.
  • Given the average cost of IVF is nearly $20,000 and many require multiple cycles to achieve a live birth, vasectomy reversals may be more cost-effective in the long run versus the number of sperm aspirations and IVF cycles it takes to conceive. Vasectomy reversals, at CNY Fertility, cost $7,900. Of course, CNY Fertility’s IVF is much less than the national average, but the cost of medications and other expenses typically make it more than a single vasectomy reversal. Regardless, it’s important to know there are options like loans and financing for both IVF and vasectomy reversals as well as numerous IVF grants.
  • With IVF, it may take less time to get pregnant and no further birth control is needed after a successful pregnancy.
  • IVF requires multiple procedures for both the male and female partners, which can be expensive and time-consuming. Vasectomy reversal is generally just one surgical procedure for the man.
  • Vasectomy reversal doesn’t always work, nor does it guarantee fertility. Ultimately you may have to have aspiration with IVF if sperm quantity and quality do not return to normal or there are other factors at play.
  • PESA/TESA/TESE are all less invasive procedures for the male partner than either VV or VE.
  • If the female partner is older (>35) and/or has not had previous pregnancies, IVF may be a better option
  • If female factor infertility is suspected, natural conception may not be possible anyway.
  • Sperm aspiration and IVF will need to be repeated if unsuccessful or if you wish to conceive additional children.

Most men will have the choice of which route—vasectomy reversal or sperm aspiration with IVF—is best for them and their partner. If you’ve had a vasectomy and are interested in learning more about your fertility options, CNY Fertility is ready to help no matter where you are in your journey.  Schedule your consultation today or give us a call 1-844-315-BABY. We’re here for you every step of the way!