Today, Dr. Natalya Lopushnyan joins us to discuss reversing a vasectomy, a procedure that allows sperm to travel into the semen and aims to restore a person’s fertility.

As with any of our blog content, this content is meant to be educational and should not be used as medical advice. Please contact your medical provider with any specific questions you may have.

Without further ado, here’s Dr. L.

Let’s talk about reversing a vasectomy…

If you’re reading this, chances are life didn’t follow the exact script you once imagined—and that’s okay. I talk to men every week who say some version of: “I never thought I’d be here, but here I am.”

Thinking about a vasectomy reversal doesn’t mean you made a mistake. It means your life, your relationship, or your priorities changed. Medicine exists to meet people where they are now—not to judge where they’ve been.

So, let’s talk about vasectomy reversal in a clear, grounded, human way.

What is a vasectomy reversal?

A vasectomy reversal is a microsurgical procedure that reconnects the tubes (the vas deferens) that were cut during a vasectomy, allowing sperm to once again travel into the semen. The surgery is performed using an operating microscope and extremely fine sutures—this is precision work, not brute force.

Finer points for those who are interested: vasectomy reversal comes in two flavors and the decision is made during surgery:

• Vasovasostomy (VV) – reconnecting the cut ends of the vas deferens
• Vasoepididymostomy (VE) – connecting the vas deferens directly to the epididymis (more complex)

You don’t get to “choose” which one you need; your surgeon will determine that during surgery and will make the most appropriate decision.

What is the success rate?

One of the biggest questions I hear is: Does reversing a vasectomy actually work?

Yes—but success depends on several factors.

Key factors that matter:

• Time since vasectomy (shorter is generally better, but long intervals can still succeed)
• Partner’s age and fertility
• Type of reversal required (VV vs VE)
• Surgeon experience (this matters more than people realize)

Realistic expectations:

• Sperm return rates: ~70–95% (varies widely)
• Pregnancy rates: ~30–70% (depends on both partners)

A successful surgery does not guarantee pregnancy. Fertility is a team sport.

Is IVF better than a vasectomy reversal?

There is no universal right answer. A reversal offers the possibility of natural conception and more than one pregnancy over time. IVF may offer a faster path to pregnancy in certain situations, but it involves procedures for both partners and is typically repeated for each pregnancy. The best choice depends on your goals, timeline, and personal values—not just statistics.

What is the recovery like?

Recovery from a vasectomy reversal is usually very manageable. It’s an outpatient procedure, and it is not a brutal recovery.

Specifically:

• Mild to moderate discomfort for a few days
• Scrotal support is your best friend.
• No heavy lifting for 2-3 weeks and no sex for a month
• Semen testing starts a few months later.

Most men are back to desk work within a week.

So who is a good candidate?

Men who are healthy enough for surgery, who understand the realistic outcomes, and who have taken the time to think this through—ideally with their partner. One thing I caution against is anyone promising a guaranteed pregnancy. Medicine doesn’t work that way, and honesty matters.

Here’s my bottom line as your friendly neighborhood urologist: A vasectomy reversal isn’t about reversing the past. It’s about honoring where you are now. The best outcomes come from good information, thoughtful decision-making, and a surgeon who treats you like a human being—not a statistic.

Good urology is about anatomy. Great urology is about people.

Request an appointment at one of our convenient locations today to get stared.