Vasectomy reversal success rates: does time since vasectomy matter?
Sperm return after most reversals performed within 20 years of a vasectomy, but pregnancy rates are lower and fall as the years pass. Here is what the UK figures show and what else changes the odds.
It is natural to want a single number for the success of a vasectomy reversal. There isn’t one. The answer depends on what you count as success, how long ago the vasectomy was, your partner’s age, and which type of join turns out to be needed during the operation. The figures below come from the patient leaflet published by the British Association of Urological Surgeons (BAUS). They describe groups of men, not any individual couple, and they are not my personal results; I give each couple a realistic estimate for their own circumstances at consultation.
What is the success rate of a vasectomy reversal?
It depends on the measure: sperm return to the ejaculate far more often than a pregnancy follows, and both rates fall as the years since vasectomy increase.
Success is measured in two ways. The first is patency: sperm reappearing in the ejaculate, which shows the join is open. The second is pregnancy. The pregnancy rate is always the lower of the two, because once sperm are back, conception also depends on your partner’s fertility. In the BAUS figures for reversals performed less than three years after a vasectomy, for example, sperm return in 97% of men but the pregnancy rate is 75%.
BAUS notes that blockages of the vas deferens are most commonly seen after vasectomy and can be overcome with a reversal. How well that holds depends above all on time, as the next section shows. If you are looking for a UK vasectomy reversal success rate, the BAUS figures are the place to start.
Sperm returning is not the same as a pregnancy
A reversal can be technically perfect and restore sperm to the ejaculate without a pregnancy following. When you compare success rates, check which measure is being quoted, and remember that your partner’s age matters as much as the operation.
How does the time since vasectomy affect the success rate?
Steadily: in the BAUS figures, sperm return in 97% of men reversed less than three years after vasectomy, but in 40% of men reversed 20 or more years later.
| Years since vasectomy | Sperm return (patency) | Pregnancy |
|---|---|---|
| Less than 3 | 97% | 75% |
| 3 to 8 | 88% | 50–55% |
| 9 to 14 | 79% | 40–45% |
| 15 to 19 | 70% | 30% |
| 20 or more | 40% | Less than 10% |
To read the table for your own situation: a reversal five or seven years after a vasectomy falls in the three-to-eight-year band, with sperm returning in 88% of men and a pregnancy rate of 50–55%. Ten years falls in the nine-to-fourteen-year band, at 79% and 40–45%. At 20 years or more the figures fall to 40% and less than 10%. BAUS states that the chance of a pregnancy is directly related to this interval and to the age of your current partner.
There is no absolute cut-off. Successful reversals are performed well over fifteen years after vasectomy, and the time since vasectomy is one factor among several, not a disqualifier.
Why does the time since vasectomy matter?
Because back-pressure builds up behind the blockage over the years and can cause a second blockage in the epididymis, which a simple rejoin of the vas cannot bypass.
Your testicles keep producing sperm normally after a vasectomy; the sperm simply have nowhere to go. Over time, that back-pressure can block the epididymis as well. If that has happened, rejoining the two cut ends of the vas, a vasovasostomy, would leave the second blockage in place. Instead, the vas has to be joined directly to the epididymis: an epididymovasostomy, also written vasoepididymostomy. It is a considerably more demanding operation that requires true microsurgical technique.
Which operation you need is decided during surgery, not before. The fluid from the testicular end of the vas is examined under the microscope: if it contains sperm, or is clear and copious, a direct rejoin is possible; if not, the epididymal join is needed. The longer it has been since your vasectomy, the more likely that becomes, and after an epididymal join sperm take longer to appear. Any surgeon offering reversal should be able to perform both operations, and should tell you in advance that the decision is made at the operating table.
Can I get pregnant if my husband had a vasectomy 10 years ago?
Yes, often: for reversals nine to fourteen years after vasectomy, BAUS quotes sperm returning in 79% of men and a pregnancy rate of 40–45%.
Those are averages, and your own age and fertility will often matter as much as the interval. BAUS’s general guidance is that reversal is the better approach when the vasectomy was less than 20 years ago, the female partner is under 35 and the couple want more than one child. Ten years after a vasectomy sits comfortably inside the first of those conditions, so at this interval your age, your own fertility and how many children you want usually decide it.
The alternative is surgical sperm retrieval with ICSI, which does not depend on rejoining the tubes. BAUS gives an average success rate for assisted conception of between 30% and 40%, again noting that the partner’s age and health affect it. I compare the two routes in detail in vasectomy reversal or sperm retrieval with IVF.
Why does the female partner’s age matter?
Because a reversal only restores sperm; whether a pregnancy follows depends just as much on the female partner’s fertility, and BAUS ties the chance of pregnancy directly to her age.
The single strongest predictor of a pregnancy after reversal is often the female partner’s age and ovarian reserve, not the surgical result. A reversal is also the slower route: you have to wait for sperm to return before you can start trying, and that delay matters more when time is short. Fertility is a couple issue, and parallel investigation avoids months of wasted time, which is why I ask for your partner to be assessed alongside you, as I explain on my male infertility page.
Does the surgeon’s technique make a difference?
Yes: the join is precise microsurgery, and the surgeon must be able to perform the more complex epididymal join if it turns out to be needed.
I perform microsurgical vasectomy reversal under general anaesthetic with the operating microscope. The ends of the vas are freshened, the fluid from the testicular end is checked for sperm, and the join is made with sutures finer than a human hair, using a two-layer technique. The operation takes between two and four hours, depending on whether one or both sides need the more complex repair. When you compare surgeons, ask whether they perform both vasovasostomy and epididymovasostomy, whether they use an operating microscope, how they will follow up your semen analyses, and whether they offer sperm freezing at the same operation.
How long does it take for sperm to come back after a reversal?
Sperm can take several months to return after a direct rejoin and sometimes a year or more after an epididymal join; the first semen analysis is at around three months.
The semen analysis is then repeated periodically. A single early negative result does not mean the operation has failed, particularly after an epididymal join, so it is important not to give up on a reversal too soon, or, if your partner’s age makes time critical, to agree in advance when you would move on to ICSI. If you are unsure what the report is telling you, my guide to semen analysis explains what it measures.
How often do reverse vasectomies fail?
Failure becomes more likely the longer the interval: BAUS reports sperm returning in 88% of men reversed three to eight years after vasectomy, but 40% at 20 years or more.
“Failure” can mean three different things. Sperm may never return to the ejaculate. Sperm may return but no pregnancy follows, which is why the pregnancy figures in the table are lower than the patency figures. Or the reversal may fail late: the join works at first and then scars and closes months or years later. Sperm freezing at the time of the reversal is often offered as insurance against late failure, so that ICSI remains possible without another operation.
Are vasectomies reversible 100% of the time?
No. The NHS states that it may be possible to reverse a vasectomy, but that this does not always work, and no surgeon can promise that sperm will return.
Even in the most favourable group in the BAUS figures, reversal less than three years after a vasectomy, sperm return in 97% of men rather than all of them, and the pregnancy rate is 75%. Reversal is a good option for many men, but it is best approached knowing that it can fail, and with a plan for what happens if it does.
Is it harder to have kids after a reverse vasectomy?
It is often slower rather than impossible: sperm take months to return, and pregnancy rates are lower than sperm-return rates and fall with time since vasectomy.
Once sperm are back, conception happens naturally, and further children can follow without more treatment while the join stays open. The practical difficulties are the wait for sperm to reappear, the possibility of late failure, and your partner’s age, which for some couples makes sperm retrieval with ICSI the better choice.
Will the NHS do a vasectomy reversal?
Not usually: the NHS’s own vasectomy information states that reversal is not usually available on the NHS.
Availability of NHS-funded fertility treatment varies between areas, so if you want to know whether anything is funded locally, including sperm retrieval and ICSI, your GP is the best person to advise on the local funding policy. If you have a reversal privately, the consultation fee is fixed, at £350 in person or £300 by video or telephone, and you receive a written quotation for the operation once a plan has been agreed. See fees and insurance for how quotations are set out.
What are the options if sperm do not come back?
Sperm retrieval with ICSI, a repeat reversal in selected men, or using sperm frozen at the original operation, which avoids a further procedure.
The NHS lists surgical sperm extraction as an option for men who have had a failed vasectomy reversal, and because your testicles are still producing sperm, retrieval does not depend on the join. This fallback is discussed before the first operation, so that you know in advance what you would do and when. If you would like a realistic estimate of your own chances, based on the interval since your vasectomy and your partner’s circumstances, you can book a consultation.
Sources and further reading
Frequently asked
Is the interval measured up to the date of the reversal?
Yes. BAUS relates the outcome to the time between the original vasectomy and its reversal, so what matters is the interval on the day of your operation, not when you first started thinking about it. The bands in the table are groupings of men, not cut-offs, but because the chance falls as the years pass it is sensible not to let the decision drift, although that is never a reason to rush into surgery unprepared.
Can I find out before surgery which type of join I will need?
Not for certain. The decision is made during the operation, once the fluid from the testicular end of the vas has been examined under the microscope. A long interval since vasectomy makes the epididymal join more likely, so I explain both possibilities beforehand and plan the operating time to allow for either. Your original vasectomy operation note is also helpful, so bring it if you can.
How many semen tests will I need after a reversal?
More than one. The first is arranged around three months after surgery, and it is then repeated periodically. Because sperm can take a year or more to appear after an epididymal join, an early test without sperm is not the end of the story: a single early negative result does not mean the reversal has failed.
What can we do to give a reversal the best chance?
Choose a surgeon who performs both types of join under the operating microscope, have your partner’s fertility assessed in parallel, and keep to the semen-testing schedule afterwards so that a slow return of sperm is not mistaken for failure. Consider freezing sperm at the time of the operation as a back-up, and agree beforehand how long you will wait before moving on to ICSI.
Why do different websites quote different success rates?
Because they are often measuring different things. Some quote patency, the return of sperm to the ejaculate; others quote pregnancy, which is always lower. Published rates also vary widely with the interval since vasectomy and the type of repair required, so a single headline figure without those details tells you very little about your own chances.
Where do you see patients about a vasectomy reversal?
I see patients at The Shard and Canary Wharf outpatient clinics, and operations take place at London Bridge Hospital. A video or telephone consultation works well for an initial discussion, although a physical examination is normally needed before surgery is planned. You do not need a GP referral if you are paying for yourself.
Speak to my team
Appointments at The Shard and Canary Wharf are arranged by my PA, Jeanette Bush. Tell us briefly what the problem is and we will find the right clinic slot for you.