Vasectomy Reversal: It’s Never Too Late

December 20, 2013

I frequently get asked if I can perform a vasectomy reversal after a prolonged period of time:

How long is too long after a vas reversal?

Am I too old to have children?

The answer is that it’s never too late.  Men seek vasectomy reversal for a variety of reasons, but the most common situation is that they had children with a partner then had a vasectomy thinking that they were done. But then there is a change of heart.

Sometimes a new partner is involved who wants to share the experience of having children with him, sometimes it’s with the existing partner and they want more children together.   Sadly, sometimes there has been loss of a child that prompts the decision.

Typically, much time has elapsed from the time of the vasectomy to the time when a man desires a vasectomy reversal.   Although I have performed reversals shortly after the initial vasectomy, most patients are years out from the vasectomy, and the average time interval is 14 yrs.

dr. karen boyle vas reversal

Can a Vasectomy be Reversed After 14 Years?

It is well know that a vasectomy can be successfully reversed even after a prolonged interval of time between vasectomy and reversal (my longest successful interval is 42 years). The question often is asked if there an age past which a reversal isn’t indicated?  In other words, can a man ever be “too old” to have a vasectomy reversal, or father a child, for that matter?

Women have a well defined “fertile period” and we know that once a woman enters her early to mid 40’s her ability to get pregnant naturally can be very challenging.   Women are born with a fixed number of eggs, and once she starts puberty and starts having her cycle, she loses eggs every month with ovulation.  A woman’s challenge with getting pregnant as she ages isn’t because she “runs out of eggs.” Rather, it is related to the age of the eggs – for a woman who is 45, her eggs are also 45. This means that her eggs may not fertilize normally or result in the birth of a healthy child.  We all know  of women in their 40s and even early 50s who have gotten pregnant, but generally speaking, most women don’t easily become pregnant at these ages, and many women seeking fertility at these ages use donor eggs as an option.

Men’s fertility, on the other hand, works completely differently. Men start making sperm once they reach puberty, and constantly make new sperm, and turn over their complete sperm reserve every 3-4 months.  As a result, men in their 40’s, 50’s, and 60’s will have normal sperm production—assuming  no other contributing condition—and their biologic age has little to do with their ability to make sperm.  Eventually age does catch up to the testicles, and we know that once a man reaches his 70s and 80s his testicles do start to fail and their sperm producing capabilities do decrease significantly.   Men at these advances still may make sperm, but their sperm counts will often not be normal.

I regularly perform microsurgical vasectomy reversal in men in their 50s and 60s, and assuming good baseline health, men in this age group make up a large percentage of the men we perform reversal on.    It is important for men regardless of age who are interested in fertility after vasectomy to know that vasectomy reversal is an excellent option for them, and the only way to conceive naturally after vasectomy.  The age of their female partner is the biggest concern when evaluating a couple who desire fertility, and we will discuss a variety of fertility options with couples where advance female partner age is an issue.


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