DEAR DOCTOR K:
I had a vasectomy many years ago. I’ve since remarried, and my new wife wants to have children. Can my vasectomy be reversed?
A vasectomy is a minor surgical procedure that is done to make a man sterile (unable to father children).
Normally, sperm — the male reproductive cells that fertilize a woman’s egg — are made in the testicle. Sperm travel away from the testicle through a tube called the vas deferens. There are two vas deferens, one for each testicle on each side. The vas deferens connect with a reservoir where the sperm is held, ready to be ejaculated during sex. The sperm also mixes with secretions from the prostate gland that keep the sperm alive. When the sperm is ejaculated, it travels through another tube, the urethra, inside the penis.
A vasectomy cuts or blocks the vas deferens. Once the vas deferens are cut or blocked, sperm cannot pass from the testicle to the reservoir where semen and secretions from the prostate gland are stored.
During ejaculation, this sperm-containing fluid is ejected through the penis during orgasm. After a vasectomy, a man continues to have normal ejaculations of semen, but the ejaculate no longer contains sperm. (I’ve put an illustration showing the path of sperm before and after a vasectomy below.)
In a traditional vasectomy, the surgeon uses a scalpel to make small incisions in the skin of the scrotum near the base of the penis. (The scrotum is the fleshy sac that contains the testicles.) The incisions allow the surgeon to reach the vas deferens in each testicle. The vas deferens are cut or blocked to prevent sperm from traveling. The surgeon may cut the vas deferens and tie the ends, burn the tubes with a hot tool, or block them with surgical clips. The incisions in the scrotum are then closed with two or three small stitches.
The other surgical option, no-scalpel vasectomy, is less invasive. Only tiny incisions are needed. The surgeon makes one or two punctures to access the vas deferens. The puncture is widened slightly, then the surgeon cuts or blocks each vas deferens. The puncture site can be covered with a tiny dressing. No stitches are needed.
A vasectomy is intended to produce permanent sterilization. Special microsurgery can reverse a vasectomy and restore fertility in some cases. But there are no guarantees that fertility or vasectomy reversal will be successful. Vasectomy reversal is a delicate, expensive procedure. And it is only successful in about 60 to 70 percent of cases.
Why would a man want to reverse a vasectomy? Often, a man and woman have fathered all the children they want to have, but want to continue to have sex. So a vasectomy is performed. But then the situation changes. The couple separates, for whatever reason, and the man’s new partner wants to have children. Fortunately, most of the time, the new couple can get their wish.