Vasectomy Reversal and Tubal Reversal: Chances of Pregnancy Success?
September 19, 2014
This is a common question posed to us by couples considering both a tubal ligation reversal and a vasectomy reversal. Unfortunately there are no great answers to this simple question because there are often many different variables that can influence the answer.
I will attempt to provide some general guidelines on how to determine your chances of pregnancy success if you are reversing vasectomy and tubal ligation.
What is the success of vasectomy reversal?
This is a much easier question to answer because the most significant predictor of vasectomy reversal success is primarily dependent on the time that has elapsed since the vasectomy. The age of the man is not that important.
If a vasectomy is reversed within the first 3 years then the chance of success is 97%. If a vasectomy is reversed after 15 years or more then chance of success drops to 69%.
What is the success of tubal reversal?
This is a more complex question to answer because it depends on several factors: age of the woman at the time of reversal, type of tubal ligation, and if regular ovulation (egg release) is occurring.
The age of the woman and the type of tubal ligation are the most important predictors.
Despite common misconception, female sterilization can be reversed and can provide a high chance or pregnancy success.
Age: Younger age is associated with higher success
Based on our experience with over 9,000 female sterilization reversals, patient age is a top predictor of success after tubal reversal. The younger a woman is when she has a reversal then the more time (or months) she has to release eggs and to achieve pregnancy. If a woman is younger than 30 the chance of pregnancy after reversal is over 80% and if she is over the age of 40 the chance of pregnancy is around 35%.
Type of tubal ligation: Conservative tubal ligations provide the best success
Reversal of tubal clips and rings provides the best chance of pregnancy after tubal reversal. Reversal of ligation and resection (tying and cutting) and coagulation (burning) when minimal amounts of tube are involved provide the second highest chance. Tubal ligations which remove of burn extensive amounts of tube provide the third highest chance of pregnancy.
Vasectomy reversal or tubal reversal: Who goes first?
I am often asked to perform simultaneous male and female sterilization reversal. I only recommend simultaneous reversals if both partners have good chances for success (minimal time since vasectomy and tubal clip or tubal ring type tubal ligations).
If the female does not have tubal ligation records or may have had an aggressive tubal ligation then I will encourage her to have her surgery first.
If the man has had a vasectomy performed more than 12 years before reversal then I will encourage the man to have his reversal first. Once sperm has returned to the ejaculate at the 3 month check then it would be reasonable to have the woman undergo her sterilization reversal.
Chances of pregnancy after tubal ligation and vasectomy reversal?
In general, I think the chances of successful pregnancy are closer to the pregnancy success rates for female sterilization reversal, which have been adequately studied in our pregnancy data base.
These statistics can be seen on our website dedicated to sterilization reversal under the section: Pregnancy Statistics.
If the man has had a vasectomy reversal within 10 years of the vasectomy then he has over a 90% chance of success and is essentially not a significant factor to be considered in the chance of pregnancy.
If the vasectomy was over 12 years then he does become more of a significant factor in the equation and consideration should be given to allowing him to attempt reversal first and after confirmation of return of sperm to the ejaculate then his partner can undergo reversal with greater confidence.
Submitted by Dr. Charles Monteith