If a man desires restoration of fertility after vasectomy, the tubes can usually be sutured back together, but this does not mean that sperm will be always restored to the semen. Therefore, this procedure should not be considered a reversible form of birth control. That being said, with shorter obstructive intervals, reversals usually work!
When performed within the first 3 years of vasectomy a reversal will restore sperm to the semen in over 97% of cases! Even when the interval between the procedure is 15 years or more, the sperm recovery rate remains about 60%.
More details about the biologic response to vasectomy and various approaches to vasectomy reversal are provided in our Vasectomy Reversal 101 page.
This procedure reconnects the tubes that carry sperm from the testicles into the semen. This allows sperm to once again be present in the ejaculate and makes natural conception possible.
It is performed using microsurgical techniques and is typically completed in a single visit. The exact method used depends on what is found at the time of surgery.
The procedure takes about 3.5 hours. It is performed under local anesthesia, similar to the anesthesia used for vasectomy. The separated vasal stumps can be sewn back together through a single 1/2-inch incision.
Reconnecting the small vasal tubes requires magnification with either a surgical microscope or optical loupes glasses. A small soft drain covered with a gauze pad is removed in the office the next day, and the small incision will seal by itself within another day or two.
Two different connections may be performed during surgery depending on what is found at the time of the procedure.
A vasovasostomy reconnects the vas deferens directly and is used when sperm are present.
A vasoepididymostomy connects the vas to the epididymis and is used when a blockage is present.
The decision is made during surgery to give the best possible chance of success.
Nationwide success statistics for this procedure are readily available, most ones commonly cited are from the Vasovasostomy Study Group, published in the Journal of Urology in March, 1991. "Success" can be define as either return of sperm to the ejaculate after reversal or by pregnancy after reversal. For both parameters, our success rates compare favorably.
The most important parameter predicting return of sperm to ejaculate after reversal is the number of years since vasectomy. Within the first 3 years after vasectomy, reversal results in sperm recovery in over 97% of cases; From 3 to 8 years, about 91%; From 9 to 14 years, about 82%; and beyond 14 years, about 69%. Click here to see a recent sperm recovery results graph.
Pregnancy rates involve female factors, which introduce many more variables. After surgery, pregnancy rates decline slowly with time (from about 86% in the 3-year group to 35% in the >15-years group). Click here to see a recent pregnancy results graph. There is no guarantee of success with this, or any other operation, but we will always we do our best to help each couple achieve their reproductive goals.
My name is Nicole and you performed a reversal on my husband, Robert, back in December, 2001. It took a while, but I just wanted to let you know that I recently found out that I was pregnant and my due date is January 29, 2004. Thank you so much for everything that you did for us.
This is just a message to report another success story. My husband had a reversal Feb. 2005 and we are happy to announce that we are expecting in April this year. His reversal was done just after 1 year of his vasectomy. We conceived in July, just 4 months after the reversal. We thank you for this blessing to add one more to our family. Kurt and Donna
Dr. Stein, I wanted to give you some updated information on my reversal. I had my reversal done on May 19th, 2005 and we just found out on Tuesday May 2, 2006 that my wife is pregnant. This is after having a vasectomy for almost 15 years and being 45 years old (my wife is 42). You do nice work!!! Thanks and God bless, Scott
The fee for office-based reversal procedures is $6900 (after a $100 consultation fee)*. We are often told that these fees are less than charges elsewhere. There are a number of reasons for this:
The rationale for our procedure fees is quite simple: this procedure takes significantly longer than a vasectomy, so we charge 10 times as much.
Sometimes during the procedure, we determine that connecting the vas to the vas has a low probability of success. This can only be determined at the time of the procedure. In this situation, the fee for that "exploration" on each side is only $475, or half of the reversal deposit. Specifically, if the lower end fluid on the first side evaluated is very poor (thick and without sperm), and a connection is not performed, then the fee for exploring that side is $475.
Then the other side is evaluated, because the two sides can be different. If the lower end fluid on the second side is very poor, and a connection is not performed, then the fee for that side is $475. By that time, the patient has already paid us $950 as a deposit, so he owes us nothing. If the lower end fluid on the second side is favorable (contains sperm), a connection is performed and the fee for that side is half of the reversal fee, which is 1/2 of $6900 = $3450.
*-If a reversal is attempted on only one side (only 1 testis or the patient wants to save money), the fee is half of the $6900 fee for both sides, plus $475, because the same amount of supplies and room preparation are needed. The deposit is the same because that is just a reservation fee that is applied toward the total fee.
A deposit of $950 and a signed reversal deposit agreement are due when the procedure is scheduled. For cancellation or postponement more than 28 days prior to the reversal, $850 will be refunded or credited. Within 28 calendar days of the reversal date, the deposit is refundable only for physician-documented illness of the patient.
The balance is due on the day of the procedure. We do not offer any type of payment plan, but we accept VISA & MasterCard, which you can pay off at whatever pace you wish.
According to the Federal Tax Code, the expenses of attaining medical treatment to correct a functional impairment (in this case sterility) are tax-deductible once the total medical expenses for the tax year (including what is spent for health insurance) exceeds 7.5% of adjusted gross income. This includes the reversal fee, airfare, mileage expenses at $0.205 per mile (2026 allowance rate for medical expenses), and lodging expenses up to $100 per night, so keep all of your receipts for tax time.
We do NOT accept CareCredit for reversal consultations or procedures.
Our office is about 25 minutes from Tampa International Airport. Patients arriving by air should arrive in Tampa at least one day before the procedure and are cleared to fly home two days after the procedure. After a reversal, patients traveling by air should be cautious to avoid lifting (including suitcases) greater than 20 lbs. Any hotel within 30 minutes of the office would be fine for those staying local. A deposit of $950 is due at the time of scheduling the reversal, but will be returned if examination reveals technical challenges too great to proceed with reversal in the office (this has occurred only twice in over 2000 reversal candidates). Patients who live over 90 minutes away by car should stay in a local hotel on the night of the reversal but may drive home after an office visit next day.