What You Need to Know About Pregnancy After a Vasectomy

There are a number of reasons a person might opt to get a vasectomy, from deciding not to have any more children to never wanting children in the first place. In fact, one in every five men over the age of 35 has elected to get a vasectomy.

However, some people get a vasectomy and then change their minds afterward. If you or your partner wants to get pregnant after having a vasectomy, there are some options that may be available.

What Is a Vasectomy?

A vasectomy is a surgical procedure that severs or blocks the vas deferens, which is the tube that carries sperm from the testicles to the urethra. When successful, a vasectomy blocks the sperm from reaching the area where it combines with the seminal fluid to create semen, which is eventually ejaculated.

“With a vasectomy, you are not stopping the production of the sperm,” explains Michael Werner, MD, medical director and founder of Maze Sexual & Reproductive Health based in New York City and Purchase, New York. “You are stopping the delivery of the sperm when [a person] ejaculates.”

There are two techniques commonly used to reach the vas deferens: the conventional incisional method, and the no-scalpel version.

The conventional incision method involves small incisions made in the scrotum so the surgeon can reach the vas deferens. By comparison, the no-scalpel version entails making a tiny puncture hole in the scrotal sac.

Research suggests the no-scalpel method takes less operating time and can reduce adverse events like bleeding and bruising, as well as infection, hematoma, and pain. At least one study found that people who underwent a no-scalpel vasectomy were able to return to sexual activity more quickly, too. But this method also requires more training than the conventional method, so it's important to find out if your doctor is prepared to offer it.

Dr. Werner favors the no-scalpel vasectomy because it’s less invasive and results in less post-operative pain. However, your healthcare provider can help you or your partner determine which procedure is best for you.

Chances of Getting Pregnant Naturally if Your Partner Had a Vasectomy

There’s a reason that experts often refer to vasectomies as “permanent birth control.” Generally speaking, vasectomies are very effective and essentially function as male sterilization. As long as the vasectomy is successful, the chances that a partner will get pregnant are very low.

According to the American Urological Association, the risk of pregnancy after vasectomy is about one in 2000. So getting pregnant without additional intervention is not very common afterward, according to Paul Gittens, MD, a urologist and founder of the Centers for Sexual Medicine in Philadelphia and New York City. However, it can still happen.

How effective is a vasectomy in preventing pregnancy compared to popular types of birth control? The numbers look good when you consider that about nine out of 100 women get pregnant in a year when using a birth control pill or a patch, according to the U.S. Food and Drug Administration (FDA).

The numbers look even better when you learn that 18 out of 100 women whose male partners use condoms may get pregnant in a typical year. However, less than one out of 100 women will get pregnant when using an intrauterine device (IUD) as contraception for a year.

Ways to Conceive After a Vasectomy

If you want to conceive after you or your partner has undergone a vasectomy, there are two options: getting a vasectomy reversal, or using assisted reproductive technology procedures like in vitro fertilization (IVF).

A vasectomy reversal, also known as a vasovasostomy, attempts to reconnect the vas deferens
restoring the flow of sperm once again. Vasectomy reversals are possible, and some are successful, but many aren't. Dr. Gittens suggests choosing a physician who has special training in vasectomy reversals to perform the procedure, as they are more complicated than vasectomies themselves.

While vasovasostomies can be done, the chances of a successful one and a subsequent pregnancy decline over time. The success rate for a vasectomy reversal is around 75% within three years of the vasectomy. It drops to 55% between four and eight years—and again to about 40 to 45% at the nine-year mark.

Some people might choose to get a vasectomy as a form of birth control with the intention of reversing it down the line. Dr. Gittens recommends against this, in the event that the vasovasostomy is not successful. “The patient should go into [a vasectomy] with the (idea that) this is a permanent form of birth control,” he says.

If a vasectomy reversal isn’t possible, is not effective, or is simply not the best option for you or your partner, you might consider IVF or another form of assisted reproductive technology. “Before you do a vasectomy reversal, it’s really important that the woman be evaluated,” adds Dr. Werner.

Basically you want to explore all your options and rule out other potential factors that might inhibit your or your partner's ability to get pregnant. For example, you'd want to rule out ovulation problems, which is a leading cause of infertility. That could include polycystic ovarian syndrome (PCOS) or primary ovarian insufficiency (POI).

How to Avoid Conceiving After a Vasectomy

Vasectomies are nearly 100% effective at preventing pregnancy. However, they don't begin working immediately after the procedure.

“The next week after [the vasectomy], they could still get their partner pregnant,” says Dr. Gittens. He typically recommends that people abstain from sex altogether for about one week post-vasectomy, and then use protection until they can get a post-vasectomy semen analysis (PVSA).

A PVSA checks to see if there are any sperm in semen. Some studies have recommended waiting until three months after a vasectomy to do the first analysis, while the American Urological Association suggests that a PVSA can be performed between eight and 16 weeks after the procedure.

If the analysis indicates that the semen sample contained any motile sperm or more than 100,000 immotile sperm, your healthcare provider may request another sample for analysis—and caution you and/or your partner to continue using another form of contraception until the results are back.

A Word From Verywell

When performed successfully, a vasectomy is a very effective way to prevent pregnancy. But if you and your partner change your minds and decide that you want to conceive after all, there are a couple of options to consider, such as a vasovasostomy or assisted reproductive technology. Talk to a urologist, a reproductive endocrinologist, or your healthcare provider to begin charting a path forward.