Exploring fertility options after a vasectomy

Patients

When it comes to family planning, contraception is key to preventing unplanned pregnancies. For many people, permanent solutions offer peace of mind, and for males, a vasectomy is considered one of the most effective methods of contraception. It is a relatively common procedure, with around 11,000 men having one each year in the UK.

However, for some men, a change in relationship status, in personal circumstance or simply of mind means that the desire to have children arises. This leaves them wondering what their options are for having a baby after a vasectomy.

Fortunately, there are several routes that can be taken. In this article, we discuss fertility after a vasectomy and the treatment options available.

What happens to your sperm count after a vasectomy?

During a vasectomy, the tubes that carry sperm from the testicles (the vas deferens) are cut or blocked to prevent sperm from being released during ejaculation. After the procedure, your body continues to produce sperm, but the sperm count in the ejaculate eventually falls to zero.

This happens over a period of about 8 to 12 weeks or after 20-30 ejaculations. This is because even after a vasectomy, some sperm remains stored in the vas deferens and reproductive track in front of where the cut or blockage has been made.

What are the chances of pregnancy after a vasectomy?

Vasectomies are approximately 99.9% effective, so the chances of pregnancy after a vasectomy are very low but not impossible. Studies suggest that the risk of pregnancy following a vasectomy is about 1 in 1000.

There are several reasons why pregnancy may still occur after a vasectomy:

Unprotected intercourse has taken place before all stored sperm has cleared, and/or a post-vasectomy semen test has confirmed a zero sperm count.
Recanalisation: This is where the cut ends of the vas deferens grow small channels that reconnect, allowing sperm to pass through again. Early recanalisation occurs in 1 in 250 patients, and late recanalisation occurs in 1 in 2000 patients.
Rare non-motile sperm: It is uncommon, but 10% of men will continue to have residual non-motile sperm at six months post op. These sperm are typically unable to fertilise an egg, but there’s still a chance pregnancy can occur.
Surgical error: Although unlikely, mistakes during the vasectomy procedure, such as cutting the wrong structure or cutting the same vas deferens twice, leaving one intact, can mean pregnancy can still happen.

Can you donate sperm after a vasectomy?

A vasectomy does not stop sperm production; it prevents the sperm from moving from the testicles through the reproductive tract and into the ejaculate. Instead, the sperm that are produced are naturally reabsorbed into the body.

For this reason, it’s not possible to donate sperm in the typical way by producing multiple samples through masturbation.

Technically, men who have had a vasectomy could still donate sperm, but it would require medical retrieval. This isn’t practical for most sperm banks, so it is unlikely that a clinic will accept post-vasectomy donors.

However, if you would like to be a donor for a known person, such as a family member or friend, then donating sperm is biologically possible – it will just be a more complex process.

Can a vasectomy be reversed?

Yes, a vasectomy can be reversed. It involves a surgical procedure to reconnect the tubes that were cut or sealed during the initial procedure.

Does a vasectomy reversal always work?

There is no guarantee that a vasectomy reversal will be successful. It depends on how long ago the vasectomy was performed, as well as other medical factors. Even if a vasectomy reversal is successful, it doesn’t guarantee pregnancy, as this is also influenced by such things as your partner’s age and whether there are any fertility issues.

The chances of getting pregnant after vasectomy reversal are:

75% if the reversal is performed within 3 years of the original vasectomy
50–55% if it’s been 3 to 8 years since your vasectomy
40–45% if it’s been 9 to 14 years
30% if it’s been 15 to 19 years
less than 10% if your vasectomy was more than 20 years ago

Fertility options after a vasectomy

If you’ve had a vasectomy reversal and it hasn’t been successful, or you either cannot or do not wish to have a reversal, there are still ways to become a parent.

Surgical sperm retrieval and IVF/ICSI

Even after a vasectomy, it is still possible to have fertility treatment using your own sperm. Because sperm production continues in the testicles, the sperm can be collected through a minor surgical procedure. This is known as surgical sperm retrieval, and it is commonly used alongside in vitro fertilisation (IVF).

There are several ways sperm can be retrieved, depending on factors such as how long ago the vasectomy was performed and the quality of sperm production. These include:

PESA (Percutaneous epididymal sperm aspiration): A fine needle is used to extract sperm from the epididymis (the coiled tube where sperm mature and are stored). This technique is quick, minimally invasive, and usually done under local anaesthetic.
TESA (Testicular sperm aspiration): A needle is inserted directly into the testicle to aspirate small amounts of tissue containing sperm. This method is helpful when epididymal aspiration is not possible or does not yield enough sperm.
TESE (Testicular sperm extraction): A slightly more involved procedure where a tiny piece of testicular tissue is removed surgically and processed to find viable sperm.

In most cases, the sperm collected is not suitable for standard IVF because the number of sperm retrieved is usually small, and they may not be motile. Instead, treatment is carried out using intracytoplasmic sperm injection (ICSI), where a single healthy sperm is injected directly into an egg. This technique allows even very limited numbers of sperm to be used successfully.

Success rates depend on factors such as the patient’s age, the quality of sperm retrieved, and overall reproductive health. However, surgical sperm retrieval combined with IVF/ICSI is a well-established and effective route to parenthood for men who have previously had a vasectomy.

We partner with London Women’s Clinic, which has been providing fertility treatments to women and couples across England and Wales since opening in 1985. They have a wealth of experience in more complex treatment, including IVF following surgical sperm retrieval.

Donor sperm

Another option for building a family after a vasectomy is to use donor sperm. This is a widely used, highly successful pathway and is suitable for individuals and couples in a range of circumstances; for example, when surgical sperm retrieval is not possible, when a vasectomy reversal has failed, or when someone simply prefers a less invasive and more predictable approach.

Donor sperm can be used with various fertility treatments, including:

Intrauterine insemination (IUI)

Washed donor sperm is placed directly into the uterus at the time of ovulation. Using donor sperm for IUI can be quick, relatively low-cost, and is often the first line of treatment for couples and single women using donor sperm.

IVF

Donor sperm can also fertilise eggs in a laboratory as part of an IVF cycle. This may be recommended if there are additional fertility factors such as blocked fallopian tubes, older maternal age, or unsuccessful attempts with IUI.

Compare donor sperm IVF versus donor sperm IUI.

ICSI

Although typically not needed with donor sperm, ICSI may be used if your fertility specialist feels it will offer the best chance of success due to factors such as unexplained female infertility, frozen eggs being used or clinical approach.

Using donor sperm from London Sperm Bank

Choosing donor sperm has several advantages. Donor sperm from London Sperm Bank undergoes a rigorous screening process for infectious and genetic conditions, and donors undergo medical and psychological assessments. This ensures the highest possible safety standards for intended parents and babies. Using donor sperm also avoids the need for surgery, making the process physically simpler and often faster.

In addition, donor conception can be a profoundly positive route to parenthood. Many families appreciate the clarity and predictability of this option, and UK regulations ensure that children conceived through donation have the right to access identifying information about their donor once they turn 18, supporting openness and long-term wellbeing.

Our donor catalogue is the largest in the UK. It’s easy to navigate, and you can search for donors that have a similar appearance to your own and align with you who are as a person. The donor sperm ordering process is also straightforward. We liaise with your clinic for delivery and keep you updated at every stage.

Expanding your family after a vasectomy may involve a few more steps, but there are still clear and successful pathways to parenthood. Whether through surgical sperm retrieval or by choosing donor sperm, many people go on to build the families they dream of. Donor sperm is a great option, with 3000 babies born from London Sperm Bank donor sperm since we opened in 2010. If you feel fertility treatment with donor sperm is the right journey for you to take, you can get started and find a donor.

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