Getting Pregnant after Vasectomy Reversal
Often times I’m asked about vasectomy reversal success rates, but of course, medical questions are rarely black and white. Let’s say the vasectomy reversal surgery goes smoothly and tests confirm that you have a positive return of sperm in your semen. By this criterion alone, your vasectomy reversal procedure was successful. But does this mean you will now be able to father children with your partner naturally? Will she become pregnant?
For any couple, there are many factors at play in a successful conception after vasectomy reversal. While sperm return after a reversal is certainly a good sign, this encouraging result does not guarantee pregnancy.
Factors that Affect Getting Pregnant after Vasectomy Reversal
Here are a few of the factors that I discuss with my patients that affect pregnancy rates after a reverse vasectomy procedure:
- Obstructive interval – the elapsed time between your vasectomy and reversal
- Female fertility
- Length of time until a good sperm count is reached
- Relative complexity of the vasectomy reversal procedure
When we talk about success rates we first need to define two terms: patency rate and pregnancy rate. Patency rate refers to the percentage of vasectomy reversals where there is a return of sperm to the semen. In other words, the operation was successful at allowing sperm to again travel from your testes to outside your body via ejaculation.
Pregnancy rate is the term for the percentage of couples who naturally conceive after a vasectomy reversal procedure. As you will see, patency rate and pregnancy rate are not the same things.
There are a lot of numbers floating around concerning the optimal obstructive interval or elapsed time between the original vasectomy and the reversal operation. According to the latest research, though, 15 years is the “magic number.” An experienced surgeon may be able to restore patency in 88% or more of his vasectomy reversal patients, even more than 15 years after their vasectomy. However, successful pregnancies after vasectomy reversal drop from 82%-89% to 44% after the 15-year mark.
This brings us to the topic of female fertility. Of course, natural conception takes two. Even if patency is successfully restored through a reversal procedure and the patient’s sperm are healthy and numerous, there can still be a problem on the female side of the equation. This is especially true if the woman has not had children in the past and thus her fertility status is unknown.
Interestingly, research shows that men who have undergone vasectomy reversal have significantly higher pregnancy rates with women with whom they have previously had a child. There is no concrete scientific explanation for this phenomenon, although researchers have proposed the higher pregnancy rate may be due to proven fertility as a couple.
Waiting for a Favorable Sperm Count
Expecting to immediately achieve conception after a vasectomy reversal is unrealistic. Most of the cells in your body replace themselves at a regular rate, and sperm is no different. In fact, it takes an average of three to four months for a complete replacement of the sperm reserve to occur.
You should also know that it may take several replenishments of your sperm before you reach your peak fertility after a reversal. While it is certainly possible for a couple to become pregnant even a few weeks after a vasectomy reversal, this is not likely. On average, the timeframe for successful conception after a reverse vasectomy is about four to nine months. Of course, this length of time can be affected by other factors, as mentioned in this outline.
Complexity of the Reverse Vasectomy Procedure
The fact is that all urological surgical procedures are NOT equal in terms of difficulty. Most of the time, a vasectomy is a relatively straightforward and simple operation. Vasectomies are also relatively common, so many urological surgeons have plenty of experience performing them.
Unfortunately, the idea persists that the surgeon who performed your vasectomy should be the same surgeon who undertakes your vasectomy reversal. Vasectomy reversal surgery, however, is extremely delicate and challenging. The surgeon is using microsurgical techniques and working with tiny anatomic structures less than a millimeter in diameter. Therefore, it takes a great deal of expertise to perform a vasectomy reversal successfully.
This difficulty is often the reason behind a vasectomy reversal failure. The surgeon may simply not have enough technical skill or experience to perform the reversal procedure successfully. Thus, it is very important that you choose an expert, specialized surgeon for your reversal procedure and not simply go with a doctor that you already know.
Even with the caveats discussed above, the majority of reverse vasectomies end in successful pregnancy. Feel free to contact us to learn more about vasectomy reversal options, benefits, and limitations.
If you’re contemplating a vasectomy reversal in New York, please contact Dr. Harry Fisch for a vasectomy reversal consultation.