Whether you’ve decided that you don’t want children, or you’re looking to take the pressure of birth control off your partner, vasectomy can be a viable path for managing your fertility.

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Since vasectomy takes a step past birth control into the category of sterilization, there are a few details to consider about your future fertility options if you haven’t yet gotten one.

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You may find yourself asking, “what if I want to have a child after my vasectomy”?

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We spoke with Dr. Shu Pan, a board certified urologist based in the Bay Area, about your options for having a child after having undergone a vasectomy.

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What is a vasectomy?

A vasectomy is a surgical procedure that is performed on the scrotum to prevent semen from being added to the seminal fluid. It is a form of male birth control that involves severing and sealing the tubes that supply sperm, known as the vas deferens, so that the sperm is no longer able to exit.

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Vasectomies are performed by a urologist, and are usually done as an outpatient procedure with local anesthetic. It is considered to be a low risk procedure.

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Unlike other forms of birth control such as condoms, IUDs, and the pill, a vasectomy is considered a form of sterilization as well as birth control. However, compared to tubal ligation, a common form of sterilization that involves sealing off the fallopian tubes so that eggs are no longer able to be fertilized, vasectomies are less invasive and come at a lower cost.

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After having undergone a vasectomy, it is important to follow up with your doctor to ensure that the procedure was successful. Your doctor will ensure that sperm is no longer passing into your seminal fluid. Until sterilization is confirmed, it is important to use an alternate form of birth control to prevent pregnancy.

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How do you get sperm if you have had a vasectomy?

The best way to preserve your options for fertility before a vasectomy is to have your sperm collected and frozen. While there are options for collecting sperm after a vasectomy, sperm freezing is a far less invasive option.

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If you have already had a vasectomy and are considering attempting to conceive, or if you simply do not want to have your sperm frozen, there are two options for regaining access to sperm for conception:

• Vasectomy reversal: In a vasectomy reversal, your urologic surgeon will bypass the obstruction at the severed ends of your vas deferens. If your vasectomy was over 10 years ago, success rates are significantly lower.
• Sperm retrieval: Sperm retrieval is a minimally invasive procedure in which sperm is collected from the testicles. In order to use the sperm your partner has to go through an egg retrieval to fertilize the eggs in the lab by a technique called ICSI (intracytoplasmic sperm injection). In most cases, sperm retrieval success is close to 100%

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What can impact my ability to get pregnant after my partner had a vasectomy?

If you and your partner are weighing the option of a vasectomy reversal in order to achieve pregnancy,  there are a few factors that you should consider:

• Age of the female partner: If you wish to become pregnant and are 35 years of age or older, you should consider your timeline for becoming pregnant. We recommend seeing a fertility specialist to confirm open tubes, a healthy uterus, and a normal ovarian reserve. You also may want to consider surgical sperm extraction combined with IVF over a vasectomy reversal, as sperm can take 3-6 months to return after one.
• Timeline of vasectomy: Vasectomy reversals are surgical procedures that require scheduling and coordination. After completion, it may take up to 6 months for sperm to return to your ejaculate."
• Time since vasectomy: The chances of a successful pregnancy diminishes with time. If the vasectomy was performed 15 or more years ago, the pregnancy rate is at best 30%.* Surgical sperm extraction can be a more effective route in this case (see reference in comment).

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According to Dr. Pan: "Fertility options exist after vasectomy, and they can be highly successful. Engage with a male reproductive specialist sooner rather than later to optimize your chances".

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I’m above the age of 35 and my partner has had a vasectomy, what should I know about my fertility?

Due to female physiology, you’re born with all of the eggs you’ll ever have. Those eggs decline in quality and quantity as you age, with a notable drop-off beginning after the age of 35.

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If you’re over the age of 35 and are planning to conceive in the future, you’ll want to see a fertility specialist to check on your ovarian egg reserve, fallopian tubes, and uterus. This will provide you and your partner with more information on your fertility so that you can choose between vasectomy reversal and a surgical sperm extraction procedure.

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After a vasectomy reversal, it can take 3-6 months for sperm to return in the seminal fluid. This timeline is further extended by the time it takes to schedule the procedure. In contrast, a surgical sperm retrieval combined with IVF is a much quicker path to pregnancy, at 2-3 months.

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Conclusion

Overall, if you’re considering vasectomy or have already had one, there are options available if you would like to try and conceive children in the future.

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If you haven’t yet had your vasectomy, sperm freezing is a great option.

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In the case that you’ve already had a vasectomy, you’ll want to consider the age of your partner, how long ago you had the procedure, and the timeline on which your partner aims to become pregnant. You can then decide between a vasectomy reversal, or the surgical extraction of sperm combined with IVF.

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At Collab Fertility, our dedicated team is here to guide and support you in making the most informed decisions for your family building journey, while prioritizing your physical and emotional well-being. We can also help you schedule an appointment with our collaborating psychologist to help you nail down your fertility goals.

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^{*Belker AM, Thomas AJ Jr, Fuchs EF, Konnak JW, Sharlip ID. Results of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group. J Urol. 1991 Mar;145(3):505-11. doi: 10.1016/s0022-5347(17)38381-7. PMID: 1997700.Belker AM, Thomas AJ Jr, Fuchs EF, Konnak JW, Sharlip ID. Results of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group. J Urol. 1991 Mar;145(3):505-11. doi: 10.1016/s0022-5347(17)38381-7. PMID: 1997700.}

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