Vasectomy Reversal

Vasectomy reversal (vasovasostomy or vasoepididymostomy) restores the continuity of the vas deferens using microsurgical techniques. Success rates (return of sperm to the ejaculate) decline with time since vasectomy: >95% within 3 years, ~75% at 3–8 years, and lower beyond 15 years.

When the obstruction is at the epididymis or significant scarring is present, a more complex vasoepididymostomy is required, with lower success rates. Overall pregnancy rates after reversal are somewhat lower than sperm return rates, reflecting partner age and other factors.

For couples where reversal is unlikely to succeed (long interval, partner age, blocked epididymis), TESE with ICSI may achieve pregnancy faster, though it bypasses natural conception.