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Vasectomy Reversal Success Rates & Failure Rates

Vasectomy Reversal Failure Rates and Success Rates Vary With:

  • The vasectomy reversal technique used.
  • The years between the vasectomy and the reversal attempt.
  • The experience and skill of the vasectomy reversal doctor.

See FAQ: 'What is the likelihood of a Vasectomy Reversal being successful and what are the factors involved?'

Some of the best vasectomy reversal success rates reported in the literature for vasovasotomy are a patency rate of 99% with a pregnancy rate of 64%, not including couples where the woman was infertile. This means that in the hands of the surgeon who quoted these rates, he was able to restore sperm flow in the vas tube 99% of the time, and this allowed a pregnancy rate of 64%.

See Vasectomy Reversal Terms & Anatomy
Compare: Success Rates of a Vasectomy Reversal Doctor in Ohio

Not every time that sperm flow returns to the vas is pregnancy guaranteed. The expected vasectomy reversal success rates results for vasoepididymostomy in the hands of the same surgeon are lower, reportedly at 65% patency rate and a 41% pregnancy rate.

Factors influencing the success rate of reversal surgery include the following:

  • Time interval since vasectomy The length of time passed since the vasectomy greatly impacts vasectomy reversal failure, as seen on this chart:
Years Between Vasectomy Sperm Return Pregnancy Rate
Under 3 years 97% 76%
3-8 years 88% 53%
9-14 years 79% 44%
Greater than 15 years 71% 30%

As previously noted, with longer intervals between vasectomy and reversal, there is an increased vasectomy reversal failure rate due to epididymal blockage as well as rupture and obstruction of the epididymal tubules.

  • Sperm granuloma Sperm granulomas at the vasectomy site are a favourable prognostic sign and increase the likelihood of vasectomy reversal success.
  • Anti-sperm antibodies Post-operative, sperm-bound antibodies result in a lower pregnancy rate or higher likelihood of vasectomy reversal failure.
  • Quality of vasal fluid The vasal fluid quality is checked before a decision is made whether to proceed with a vasovasotomy versus vasoepididymostomy when reversing the vasectomy. If no sperm are present in the vasal fluid the gross apearance of the vasal fluid can help in determining between a vasovasotomy versus vasoepididymostomy. Cloudy, water soluble fluid indicates the best case for eventual return of sperm to the semen (higher vasectomy reversal sucess rate). Thick white greasy toothpaste-likematerial indicates the worst prognosis (a higher vasectomy reversal failure rate).
  • Microsurgical Vasectomy Reversal Technique The vasectomy reversal technique and the doctor`s judgment and experience are important factors for success. Given that choosing the vasectomy reversal doctor is one of the few choices controlled by the patient, it may become an important factor in determining the vasectomy reversal success rate.
  • Associated conditions Any condition that impairs sperm production for example a varicocele may lower postoperative pregnancy rates (increase vasectomy reversal failure rate).

Vasectomy Reversal Failure Followed by Repeat Vasectomy is Reasonable

  • In one study that looked at the patency and pregnancy rates of a repeat attempt at vasectomy reversal, success rates only dropped slightly: the second reversal surgeries yielded a 75% patency rate versus a 86% patency rate for vasectomy reversals that were successful in the first attempt.
  • In another study group where success was obtained on the first attempt reversal surgery, second attempt reversal surgery yielded a 43% pregnancy rate compared to a 52% pregnancy rate on the first attempt.

Therefore it is not necessary to give up after a vasectomy reversal failure. However, one may want to look carefully at making sure the second attempt maximizes the vasectomy reversal success rate by examining all the factors responsible for a successful surgery.

Time Interval to Determine Vasectomy Reversal Failure or Success

Post vasectomy reversal, determining success with a vasovasotomy, often takes three months or more for the semen analysis to reveal a good sperm count. Sperm count usually will be better quality after six months.

Vasectomy Reversal Success Rate Maximized by Not Delaying

After a vasoepididymostomy, sperm usually takes longer to appear in the ejaculate and in most cases can take four to six months. In general, the first semen analysis after a vasectomy reversal is often obtained within one or two months, and then every two to three month after until sperm counts and sperm movement are normal, or until pregnancy occurs.

It is best not to delay having a vasectomy reversal. Even if a couple does not plan to conceive right away, vasectomy success rate is optimized by not delaying. The average time interval from vasectomy reversal until pregnancy is twelve months, and it can often take two years or longer for the highest percentage of pregnancies to be achieved. Couples must also consider that after an initially successful vasectomy reversal, i.e., when patency is achieved, a vasectomy reversal failure is still possible. A late obstruction will occur in up to 12% of men by fourteen months after the operation. This means that if sperm flow is demonstrated after vasectomy reversals, couples should not wait to attempt achieving a pregnancy. At a minimum, semen should be stored for future use should pregnancy fail to occur with regular intercourse.

The vasectomy reversal failure rate is real. When failure occurs its extremely disappointing, expensive and emotionally difficult. What is necessary to maximize the vasectomy success rate, especially when the first vasectomy reversal fails, involve various listed factors. However the biggest factor is your choice of surgeon. Determine the vasectomy reversal doctor’s experience and vasectomy reversal success rate, especially if epididymal reconstruction will be necessary.

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