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Are Vasectomies Reversible, Can I still have a baby?

Vasectomy is a permanent form of birth control.  There are a number of tubes inside the scrotum that perform various functions including carrying blood to and from the testes. These structures also regulate temperature of the testes and slightly pull the testes up, or lower them depending on the situation.  There are also two tiny tubes (one for each testi) that carries sperm from each testi; these tubes are named the vas deferens.  A vasectomy is a minor procedure where the vas deferens in divided (ie cut) so sperm can no longer get out of the body.  So how can you still have a baby after a vasectomy?

While the vas deferens may have been divided, preventing more sperm getting through, the body stores a large number of sperm above the cut in two large storage tanks named the seminal vesicles.  The seminal vesicles, along with the prostate, provide some of the secretions of semen.  After a vasectomy it takes time for these storage tanks to empty of sperm.  Most men have emptied the seminal vesicles of sperm after 20 or so ejaculations but for some men it takes longer, even a lot longer.  The seminal vesicles are convoluted.  That is to say, they twist and fold back on each other and have a lot of blind endings (almost like a sock).  It is possible for sperm to hide all the way down the end of these structures (where your toes would go).  They fail to get flushed out efficiently and that is one reason why it can take a lot more than 20 ejaculations for some men to empty their seminal vesicles of sperm.  Older men tend to have less powerful ejaculations, so older men often take longer to completely clear the sperm out of the seminal vesicles.  You should continue to wear condoms until the sperm is emptied out. So can you still have a baby after a vasectomy? Definitely!  I have seen a handfull of pregnancies from men who had unprotected sex too soon following their vasectomies in Queensland.  

Even in a technically successful or routine vasectomy there is a chance that one, or both, of the vas deferens may heal back together.  The chance of this happening is about one in 750. 

Following the vasectomy the last bit of healthy tube on each tip (top and bottom) sprouts tiny fibrils that search each other out. I like to think of it as the roots of a tree.  If one of the top fibrils meets one of the bottom fibrils they can grow a new tube, or channel, for sperm to pass through.  I personally think it makes more sense to call this new channel a bypass, rather than a rejoin or recanalisation.  Doctors have a term for the clump of tissue (fibrils, tree roots or new tubes, or whatever you’d like to call them) called a Medusa’s head.  Medusa was a Greek monster with snakes for hair.  It seems that after a few months the body gives up trying to heal itself and the fibrils start to die off. This appears to have happened by week 12 following the vasectomy and that is why we recommend doing a test to check for a rejoin after this date. There is some evidence that for a lot of men, the body gives up trying to rejoin from 8 weeks, but there isn’t enough evidence to recommend testing at the earlier stage.  For Vasectomy Queensland men it may be hard to find a nearby pathologist who does sperm tests.  You may need to drive your sample into your regional town centre.  It is worth letting them know the day before so they can arrange a courier or someone to test the sample on site.  Can you still have a baby after a vasectomy?  You bet. That’s two ways. So please wait the 20 ejaculations and 12 weeks before doing the sperm test.

Can you still have a baby after a vasectomy and emptying the seminal vesicles and getting a clear test?  Yes, however this is very very rare (it is a similar risk to being struck by lightning).  It is called a late recanalization and vasectomy doctors have a lot of theories about what is actually happening.  One theory is there are some super fibrils that forgot to die off at week 12, they continued to grow and so only joined up after the test.   Another theory is that some super strong sperm managed to “jump the gap” between the two tubes and have found their way to an egg.  The leading theory at the moment (and the one I think most likely) is the tubes actually rejoined in the initial weeks following the vasectomy but did so with a small flap of tissue in the middle.  This flap can act as a valve and was obviously closed at the time of the test, but at some random night in the future, the pressure inside the tube was right for the valve to open and some sperm to get through.  If this lines up with an egg that’s how someone can still have a baby after a vasectomy.  This also explains how a man can have a normal vasectomy, a clear test, go on to father a child and then do a subsequent test where there is no sperm.  This also brings up the alternative possibility of infidelity.  I have had two of my vasectomy Brisbane patients contact me following an unexpected pregnancy.  Both of these men had routine vasectomy procedures and clear tests where no sperm was seen.  In neither instance was there any suggestion of infidelity.  These men and their partners had done everything right but did not get the result we were all after. For the mathematicians; that is 2 late recanalization out of about 11 000 procedures. Another way of looking at that is saying if you have a routine vasectomy and clear test, you are 99.99% safe 

There are a few different ways of performing a vasectomy and they do have slightly different risks when it comes to failure. The number of vasectomies the surgeon has performed also appears to make a difference.   With all of the above being said, vasectomy is still the most reliable form of contraception.  The risk of having a baby after a vasectomy in Brisbane is incredibly low.  Please wait and do the test but assuming you are clear, I would worry about something else. If you are searching, can you still have a baby after a vasectomy because you have had a vasectomy and your partner is pregnant, don’t stress or jump to any conclusions. Please contact the doctor who did your vasectomy or feel free to talk to one of our nurses at Vasectomy Queensland to discuss your situation.

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