Vasectomy Reversal (Vasovasostomy / Vasoepididymostomy)

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated July 27, 2026

Vasectomy reversal is microsurgical reconnection of the vas deferens after prior vasectomy, restoring the pathway for sperm to reach the ejaculate and enabling natural conception. Two techniques exist. Vasovasostomy joins the cut ends of the vas deferens directly and applies to most cases. Vasoepididymostomy bypasses an obstruction inside the epididymis, joining the vas deferens directly to a patent epididymal tubule above the blockage; surgeons must use it when secondary epididymal obstruction has developed upstream, a complication more common with longer obstructive intervals. The choice is made intraoperatively based on fluid analysis and is not determined in advance.

Outcomes depend heavily on the interval between vasectomy and reversal. The Vasovasostomy Study Group analyzed 1,469 microsurgical reversals. Among the 1,247 first-time procedures, patency reached 86% (865 of 1,012) and pregnancy occurred in 52% of couples (421 of 810) with available follow-up data. Stratified by obstructive interval: under 3 years yielded 97% patency and 76% pregnancy; 3 to 8 years yielded 88% and 53%; 9 to 14 years yielded 79% and 44%; 15 or more years yielded 71% and 30%.¹ Female partner age is an independent determinant of cumulative pregnancy outcome and should be evaluated alongside the male obstructive interval.

Vasectomy reversal is the restorative approach to post-vasectomy fertility. It addresses the obstruction directly. The alternative, surgical sperm retrieval combined with intracytoplasmic sperm injection (ICSI), circumvents the vas entirely and removes the female partner from natural conception, requiring ovarian stimulation and embryo transfer procedures that carry their own risks. When the couple is counseled together and the female partner has no significant fertility concerns, restoration of the vas pathway is the cause-based approach.

Both partners require evaluation before any surgical decision. Male factor, female factor, and the couple's goals all shape the clinical picture.

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.