It is amazing how common it is for someone to have had a “permanent” sterilization procedure only to find life changes that plan. When people change relationships or simply want another child when they thought they were done, multiple questions arise. These include: 

How long will it take to get pregnant after the reversal? When is the right time to have this procedure done? How painful is the reversal procedure and what is the recovery time? Let’s answer these!

How long does it take to get pregnant after a tubal reversal or vasectomy reversal?

If you have had a tubal ligation or a vasectomy in the past and now want to have a baby, you may wonder how long it takes to get pregnant after reversing these procedures. The answer depends on several factors, such as your age, your partner’s fertility, the type of surgery you had, and how long ago you had it.

Tubal ligation reversal is a surgery that reconnects the fallopian tubes that were cut or blocked during a tubal ligation. This allows eggs to travel from the ovaries to the uterus again. Vasectomy reversal is a surgery that reconnects the vas deferens that were cut or blocked during a vasectomy. This allows sperm to travel from the testicles to being ejaculated again.

Both surgeries are usually done as outpatient procedures under general anesthesia. The recovery time is usually about one to two weeks for both men and women, but generally, men recover a bit faster because the scrotum is more accessible than the Fallopian tubes, which can help with recovery. However, getting pregnant may take longer than that. Some specialists may advise waiting for one or more menstrual cycles before trying, so it’s important to talk with your specialist regarding specific needs.

According to some studies, 50 to 80 percent of women after tubal ligation reversal become pregnant within a year. However, up to half of these can be ectopic (tubal) pregnancies or miscarriages, where some only see live birth rates of 25-40% after tubal reversal. The chances of getting pregnant after tubal ligation reversal depend on various factors, such as your age, your partner’s sperm quality, the type of tubal ligation you had, and how much healthy tube remains after reversal. 

Most women who’ve had tubal ligation assume that once they simply untie the tubes they will be easily pregnant. However, not only can getting older meaningfully affect chances, but ligation can permanently change the Fallopian tube. If a pipe is capped off, even when uncapped, there can be corrosion within the pipe that changes it. Similarly, even after putting the tube back together, there can be damage to the cilia (little hairs that push sperm and egg together and then propel the embryo to the uterus after fertilization), lowering fertility despite successful reversal. Also, if there is previous tubal damage, reversal is less likely to be successful. Women with a history of gonorrhea, chlamydia, or endometriosis, may end up being worse than average candidates for tubal reversal.

For men who have a vasectomy reversal, it may take longer for sperm to appear in their semen again. This depends on how long ago they had their vasectomy and whether they developed scar tissue or antibodies that affect their sperm quality. Some men may see sperm in their semen within three to six months after surgery, while others may take up to a year or more to fully recover their numbers. The chances of getting pregnant after vasectomy reversal also depend on various factors, such as your partner’s age and ovulation status, the method of vasectomy you had, and how well the surgery went. On average, about 50% of couples who have vasectomy reversal will achieve pregnancy within one year. Of note, vasectomy reversal is not associated with an increased risk for ectopic (tubal) pregnancy.

If you are considering having either of these surgeries reversed, it is important to consult with a specialist about your chances of conceiving. You may also want to explore other alternatives for having a baby, such as in vitro fertilization (IVF) or using donor eggs or sperm. These methods may offer higher success rates than reversing sterilization, as success often relates to your unique medical profile.

When is the right time to have a tubal reversal or vasectomy reversal done?

In addition to appropriate evaluations, it’s important to consider the timing of these procedures. In general, the sooner a vasectomy reversal is performed, the better the chances of success. However, as time goes on, the chances of success decrease, and there is an increased risk of developing additional obstructions in the vas deferens. Therefore, it’s crucial to discuss the timing of the procedure with a healthcare provider.

According to the Mayo Clinic, pregnancy rates after a vasectomy reversal can range between 30% to over 90%, though most are lower than 90%. However, success rates start to particularly decline after 15 years, due to greater antibody formation and increased paternal age. For women who have tubal ligation reversal, pregnancy rates range from 40% to 85%, depending on their age and the method of tubal ligation they had, though miscarriages and ectopics (tubal pregnancies) can account for up to half of these pregnancies.

Another factor to consider when deciding on the right timing for a reversal surgery is your age. As you get older, your fertility naturally declines. This means that even if you have a successful reversal surgery, you may still face difficulties getting pregnant due to other factors such as egg quality or sperm count. For women over 35 years old and men over 40 years old, reversing sterilization may not be enough to achieve pregnancy without additional help from methods like the previously mentioned in vitro fertilization. 

Though many focus on a woman’s age, advanced paternal age can also play a role in the success of these procedures. As men age, there is an increased risk of developing DNA damage in their sperm, which can lead to an increased risk of birth defects and miscarriages. Therefore, it’s important to discuss the potential risks associated with advanced paternal age with a fertility specialist who can guide you through your fertility journey.

How painful are tubal and vasectomy reversals and what is the usual recovery time?

Another question common to those considering reversal is simply: how much will it hurt, and how long will it take to go back to normal? The answer is not definitive, as it depends on each patient’s specific factors. But pain and recovery time generally depends on factors like the type of surgery you have, your health condition, and your pain tolerance.

Tubal reversal and vasectomy reversal both involve reconnecting the tubes that were cut or blocked during sterilization. Tubal reversal is a major abdominal surgery that requires general anesthesia and usually takes 2 to 4 hours to perform. A vasectomy reversal is a minor surgery that requires local anesthesia and can also take around 2 to 4 hours to perform.

Both procedures can cause some pain and discomfort after surgery, though this also depends on your pain tolerance level. You may have bruising, swelling, and soreness in your groin and scrotum area if you have a vasectomy reversal. You may have abdominal pain, cramping, bleeding, and gas if you have a tubal reversal. Your specialist will most likely prescribe you some pain medication to help you cope with the pain. Your specialist will also advise you to avoid strenuous activity or sexual intercourse until told otherwise.

The recovery time for these procedures varies depending on how well you heal and follow your doctor’s instructions. Generally speaking, most men who have a vasectomy reversal can return to work within a week, while most women who have a tubal reversal go home the same day if the procedure is done laparoscopically or robotically. If the tubal reversal is done by a mini-laparotomy (typically smaller than the bikini cut incision for a Cesarean), some women will be observed overnight before returning home to rest for 7 to 10 days. You should keep the incision site(s) clean and dry and watch out for any signs of infection or complications.

Tubal reversal and vasectomy reversal are both effective ways of restoring fertility after sterilization. However, because they can have some challenges and because the balance of risk and benefits is specific to each person, you should weigh these pros and cons carefully with a fertility specialist before deciding on the approach that is best for you, including alternatives.

Regardless of where you are on your fertility journey, it’s important to have a medical professional join you for the answers you need. Don’t suffer in silence. Reach out to a fertility specialist today for answers, peace, and results.