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Vasectomy Reversal: Does Age Matter?

The fact that fertility declines with age seems both true and logical, but it turns out that it might not be true for men, at least not under these circumstances. A new study finds that vasectomy reversal has similar results, regardless of age.

February 15, 2021
Charlotte Pearse

Not everyone wants children, and you would think men who choose to get vasectomies would be included in that group. You may be wrong.

A vasectomy is a surgical procedure in which the tubes that carry sperm from the testicles to the penis are cut or otherwise blocked off, and it prevents any sperm from getting into the semen. If the sperm cells can’t reach the semen, they can’t reach the egg either. Problem solved.

It’s not quite that simple, however, as unlike the tubal ligation used for women, vasectomies are reversible, and a surprising number of men who get vasectomies actually want to have children in the future. 

Male fertility begins to decrease around 40 to 45 years of age. However, according to a study done recently by Keck Medicine of USC, men over 50 have the same rate of successful pregnancy as younger men following a vasectomy reversal.

The Stigma

There’s plenty of negativity and misconceptions surrounding vasectomies, which may discourage men from getting one. Vasectomies are very rare in that they are a surgical sterilization procedure that can be, in fact, temporary. Why are some so against the idea?

Many men worry that getting a vasectomy will be a long, painful process that takes them a long time to recover from, but recovery is apparently fairly quick as long as one gets enough rest. 

This is, on average, about a week. Patients should wait a few days before engaging in a lot of physical activity.

In addition, they are generally not too painful, though some discomfort is to be expected. Anesthesia will be administered for the procedure itself, and after that a combination of over the counter painkillers and ice packs should be enough to help.

The pain shouldn’t last longer than a week, and the actual surgery only lasts 20-30 minutes. A reversal, on the other hand, takes several hours, but only up to 2 weeks for recovery, though strenuous activity should be avoided for a full month. 

An image of two masked and gloved doctors performing a surgical procedure.
Vasectomies and vasectomy reversals are surgical procedures, but they rarely lead to serious complications.

Many believe that vasectomy reversals, an entirely different procedure than getting one in the first place, can be unsuccessful and result in a pregnancy anyways. 

As our technology and medicine have improved, so have vasectomies, and now only 1-2 women out of every 1,000 have an unplanned pregnancy after their partner got a vasectomy. 

And those 1-2 cases are more likely than not instances of the couples not waiting long enough for the sperm to clear from the semen, which could take up to 20 ejaculatory emissions.

On the opposite end of the spectrum, some men believe that getting a vasectomy will make them unable to have children for the rest of their lives. 

The success of a reversal can depend on many factors, such as how the initial sterilizing was done, how healthy the patient is, and how long it’s been since the first procedure— reversals are less likely to succeed the longer you wait.

The study detailed below was done for men who have similar doubts.

The Study

Mary Samplaski, a specialist on male infertility, was the lead investigator of this study. Together with Keck Medicine of USC, she compared the outcomes of over 3,000 men who had a vasectomy reversal.

2,777 of these men were at least 50 years old, and 353 were younger than 50. The mean age of the former was 54 and the latter was 39.

Researchers found that 33.4% of the younger men were successful in trying for a pregnancy, and 26.1% of the older men had the same results.

Samplaski and her colleagues found no association from these statistics between age and at the time of the reversal and pregnancy.

An image of black and white graphs on a computer screen.
The research results surrounding pregnancies following vasectomy reversals were released on December 17th, 2020. The findings were published in the journal Urology.

Several other correlations were found through this study, however, other factors were also looked into. These included the age of the mens’ partners, the number of years since the men had originally had a vasectomy, and history of smoking.

They found that a pregnancy was a more likely result if partners were younger than 35 or if the vasectomy had taken place less than 10 years prior to the reversal. In addition, a history of smoking lowered the likelihood of pregnancy.

But according to Samplaski, “age had no bearing on success.” It was not an independent factor. So, she and the other researchers believe that a vasectomy reversal should definitely be considered by older men who want to have children as well as younger.

The Significance

The researchers involved in the study believe that now men may be less hesitant to get a reversal following a vasectomy. 

Samplaski in particular hopes that older men will see these findings and be encouraged rather than discouraged to do so if they wish to have children.

After all, 20% of men who get vasectomies want to have children later in their lives, and yet only 6% get their vasectomies reversed. Now we know that though fertility decreases with age, the likelihood of pregnancy following a reversal doesn’t change.

An image of a man and a pregnant woman sitting on a bench, each holding one of a pair of baby shoes.
Pregnancy is still very possible even if you or your significant other got a vasectomy in the past.

The other option for men who wish to have children but have already gotten a vasectomy is, of course, IVF where the sperm cells are removed from the body altogether and directly fertilize the egg in a lab to later be moved to the uterus.

While a fantastic option, hopefully going forward men will be willing to try vasectomy reversals as well, and they will be seen as less taboo and more safe.

As Samplaski said, “The bottom line is, men over 50 can have successful outcomes in achieving pregnancy after vasectomy reversal, and it should be considered a very viable option.”


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