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Contraceptive Pearl: Vasectomy Reversal

Written by Deyang Nyandak, MD.

Vasectomy is a safe and effective permanent birth control method. Six to eight percent of married couples in the world rely on this method¹. Compared to vasectomy, tubal ligation has 20 times the risk of major complications and three times the cost²

Some patients regret vasectomy and wish to conceive. People can opt for a vasectomy reversal procedure or in vitro fertilization with intracytoplasmic sperm injection. For most people, neither procedure is covered by insurance. Vasectomy reversal procedures cost $6,000 to $15,000³.

Pregnancy rates after vasectomy reversal range from 14 to 67%. Pre-vasectomy fertility, the skill of the surgeon, partner’s previous fertility, previous conception with current partner, partner’s age less than 40, a shorter interval between vasectomy and reversal, and the absence of post-vasectomy complications or pelvic/inguinal surgery are positive predictors of a successful reversal.  

Vasectomy is meant to be a lifelong, permanent method of contraception, and pre-procedure counseling should make this clear. However, for people who desire fertility after vasectomy and can afford an expensive procedure, reversal is an option.


Resources:

Your Birth Control Choices Fact Sheet

Vasectomy User Guide


Sources:

Pile JM, Barone MA. Demographics of vasectomy–USA and international. Urol Clin North Am. 2009;36(3):295-305. doi:10.1016/j.ucl.2009.05.006

Trussell J, Lalla AM, Doan QV, Reyes E, Pinto L, Gricar J. Cost effectiveness of contraceptives in the United States [published correction appears in Contraception. 2009 Aug;80(2):229-30]. Contraception. 2009;79(1):5-14. doi:10.1016/j.contraception.2008.08.003

How much does a vasectomy reversal cost? CostHelper. Accessed February 8, 2022.

Patel AP, Smith RP. Vasectomy reversal: a clinical update. Asian J Androl. 2016;18(3):365-371. doi:10.4103/1008-682X.175091

Silber SJ. Pregnancy after vasovasostomy for vasectomy reversal: a study of factors affecting long-term return of fertility in 282 patients followed for 10 years. Hum Reprod. 1989;4(3):318-322. doi:10.1093/oxfordjournals.humrep.a136896

Boorjian S, Lipkin M, Goldstein M. The impact of obstructive interval and sperm granuloma on outcome of vasectomy reversal. J Urol. 2004;171(1):304-306. doi:10.1097/01.ju.0000098652.35575.85


Pharma-free

The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.