Is a Vasectomy Reversible? Roe v. Wade News Prompts Questions

Since the leak about Roe v. Wade being overturned, people across the country are having broader conversations about reproductive rights and the options that remain available should the Supreme Court proceed as predicted. One of those available options is a vasectomy. 

Eric Rodriguez, CEO and cofounder of Innerbody Research, who conducted research on trending topics right after the Supreme Court opinion leak last week, says online searches for vasectomy information have spiked during the month of May.

Searching for the cost of a vasectomy has become 250% more common. There’s a similar increase in search volume for whether or not vasectomies are reversible. This could indicate that men are taking action to prevent unwanted pregnancies as female reproductive health becomes more restricted.

“Vasectomies are one of many highly effective birth control options nowadays,” said Rodriguez. “If you don’t have sperm entering your semen, the likelihood of pregnancy drops off significantly. With a 99% effectiveness rate and being reversible, vasectomies are a safe option for males looking for a birth control method.”

Vasectomies are meant to be a permanent form of birth control. Unlike intrauterine devices (IUDs), which can last three to ten years, a vasectomy is treated as though it will act as birth control for the rest of the patient’s life.

But sometimes, a life change means a person who had a vasectomy wants a reversal—and that is possible.

How Do Vasectomies Work? 

Verywell talked to Jim Dupree, MD, urologist at the University of Michigan Health, to learn more about vasectomies and vasectomy reversal.

“Sperm are made inside the testicle, sperm that are moved into a gland called the epididymis on the back of the testicle, and then sperm are pushed through a tube call the vas deferens,” said Dupree. “The vas deferens is the tube that basically carries sperm from the scrotum up into the prostate for then go out during sexual activity.”

Vasectomies stop sperm from getting in the semen by cutting the vas deferens.

“After a vasectomy, a patient continues to make sperm. It’s just that the sperm are blocked and don’t have a way to kind of get up to the prostate and kind of get out of the body as they normally would,” said Dupree.

Dupree’s clinic has a very specific procedure for vasectomies.

“What I do is I remove a small segment—maybe one to two centimeters of the [vas deferens] tube—and then I also cauterize the very inner lumen of the tube to try and kind of seal that tube closed,” said Dupree. “The third thing that I do is sew a layer of tissue in between those two cut ends to provide a physical blockage to reduce the risk of those two cut-ins growing back together.”

Dupree added that this procedure has to be completed for both testicles.

How Do You Reverse a Vasectomy?

While vasectomies are intended to be permanent procedures, it’s still possible to reverse them if a family’s situation has changed.

“A reversal is one of the ways that a patient can try and have a bigger family after a vasectomy,” said Dupree. “I take the vas deferens tube and make a fresh cut on either side of where the vasectomy was performed. Then, I bring those freshly cut ends back together and sew them together with some very very delicate sutures—smaller than the human hair.”

Reversals work better if it hasn’t been too long since the initial vasectomy surgery. If it’s been more than a decade, complications can impact how urologists like Dupree perform the reversal procedure. 

“If it's been a long time, the patient can develop a second blockage upstream towards the testicle, usually in the epididymis,” said Dupree. The epididymis is a duct behind the testicle. "During the surgery, we can identify if that's occurred. There's a plan B, which is to sew the vas deferens to directly to the epidermis itself and sort of bypass that epididymal blockage.”

Vasectomy Reversal Success Rate

Vasectomy reversals are usually effective, but they aren’t perfect.

“If we’re able to do the first of those two types of surgeries that I mentioned…the success rate of removing sperm from the ejaculate is about 95%,” said Dupree. “If we have to do the other surgery that I mentioned, the one where we sew the vas deferens directly to the epididymis to bypass blockages, there’s a lower success rate of 60% to 65%,” said Dupree.

Reversals aren’t successful right away, and it can take up to three months after the procedure for sperm to be present in the semen again, according to Dupree. How a patient heals will also have a big impact on how quickly the reversal can take effect.

“For patients who get that second surgery—the bypass connection from the vas deferens directly to the epididymis—sometimes it can take even longer for the swelling to go down and for us to start seeing sperm in the ejaculate,” said Dupree.