With the recent supreme court ruling, more men, specifically younger men are choosing vasectomy for contraception. This is the most effective and reliable form of male contraception and a good option for those who are certain that they don’t want any additional children.

Although men should be made aware that vasectomy is a permanent form of surgical sterilization, it can be reversible under certain circumstances (i.e. you can still have a baby after a vasectomy). Up to 10-20% of men and their partners may desire children or additional children after vasectomy but less than 1% do. I hope to answer some common questions about fertility after having a vasectomy.     

There are two ways to have a child after a vasectomy – 1) vasectomy reversal or 2) sperm retrieval. Vasectomy reversal seems the most intuitive and may be preferred in most couples. Typically, this requires a 2-3 hour delicate microsurgical procedure through an incision in the scrotum to reconnect the ends of the vas deferens or the tube that has ligated during the vasectomy. Recovery is minor, and most men can resume all of their normal activities by 4 weeks after surgery. Success rates, when completed by a high-volume microsurgeon, are very high (>90%) if success is defined as reestablishing the flow of sperm in the ejaculate. Unfortunately, this does not correlate with successful pregnancy that must also consider factors from the female side – the most important being age. However, pregnancy rates are as high as 50-80% after successful vasectomy reversal.      

Even after vasectomy men continue to make sperm but it is not deposited in the ejaculate. Surgical retrieval will get sperm directly from source (upstream of the vasectomy site). This can be completed with the passage of a small needle through the skin directly into the testicle or epididymis. Unfortunately, this sperm would need to be used for artificial reproduction since you would not be able to conceive naturally as the flow of the sperm into the ejaculate has not been reestablished. Pregnancy rates are as high as 50% with surgical sperm retrieval and in vitro fertilization.          

Some couples are surprised to learn that a vasectomy reversal is not typically covered by insurance. Generally, a vasectomy reversal is still the most cost-effective option for most couples who want more children. A vasectomy reversal roughly costs around $10,000 compared to surgical retrieval and in vitro fertilization which could be upwards of $25,000.     

Although having children after a vasectomy is possible, it is not always straightforward. It is important to seek out a fertility provider that could offer both options and determine what is the best for you and your partner.

-Dr. Patel