If a man has had a vasectomy and changes his mind at a later date about the desirability of further children, an operation can be performed to rejoin the severed tubes a vasectomy reversal. The aim is to restore continuity to the tubes and allow sperm to flow into the ejaculate again.
A vasectomy reversal is a much more complex procedure than a vasectomy and is always performed under general anaesthesia. The operation takes about two hours and is technically demanding. The ends are usually rejoined under magnification and some surgeons use an operating microscope to allow the accurate placement of the very fine stitches.
The success of the operation depends on the skill of the surgeon and the length of time that has elapsed since the vasectomy. If the reversal takes place within three years of the vasectomy then sperm will usually be found in the ejaculate after the reversal, and 75% of couples will achieve a pregnancy. If between three and eight years have elapsed around 50% of couples achieve a pregnancy. Only around a third of couples will achieve a pregnancy if more than 10 years has elapsed since the vasectomy.
If the operation fails, a pregnancy can still sometimes be achieved using techniques of in vitro fertilisation (IVF) using sperm harvested from the epididymis, testis or vas. Sperm can be collected for deep frozen storage at the time of the reversal operation so that if the reversal operation is unsuccessful, the frozen sperm can be used for IVF. This means that the patient does not have to undergo a separate operation at some point in the future to have sperm harvested.