Vasectomy Reversal Specialist on Long Island
Microsurgical Vasectomy Reversal — Restoring Fertility After Vasectomy
Vasectomy Reversal — A Second Chance
Circumstances change. A new relationship, the loss of a child, or simply a change of heart — whatever brought you here, vasectomy reversal is a real option that restores the possibility of natural conception.
A vasectomy reversal is a microsurgical procedure that reconnects the vas deferens, allowing sperm to once again flow through the ejaculate. Dr. Kashani performs the procedure using microsurgical techniques and a high-powered operating microscope — the same approach used at major academic centers.
The procedure is performed as an outpatient surgery under general or regional anesthesia. Most men go home the same day and return to desk work within a week.
Time matters: The sooner a reversal is performed after the original vasectomy, the higher the success rate. It is always worth a consultation to understand your specific chances.
Sources: Belker et al., J Urol 1991; Herrel et al., Urology 2015.
Two Types of Vasectomy Reversal
During your vasectomy reversal, Dr. Kashani will determine which procedure is needed based on what he finds at the time of surgery. This decision is made intraoperatively — you cannot know beforehand which one will be required.
Vasovasostomy
The two cut ends of the vas deferens are reconnected directly. This is the simpler of the two procedures and is performed when sperm are found in the fluid from the vas deferens during surgery — confirming there is no blockage downstream. It has the highest success rates.
Performed when the vasectomy was more recent and no epididymal blockage is present. Sperm typically return to the ejaculate within 3 to 6 months.
Vasoepididymostomy
When no sperm are found in the vas fluid — often because of a secondary epididymal blockage that develops over time — the vas deferens is connected directly to the epididymis, bypassing the blockage. This is a more technically demanding procedure requiring advanced microsurgical expertise.
More likely needed when the vasectomy was performed more than 10 to 15 years ago. Success rates are lower but still meaningful — and it is the only surgical option for these cases.
Why this matters: Not every urologist is trained to perform a vasoepididymostomy. Dr. Kashani has fellowship training in male reproductive surgery and is prepared to perform either procedure — whatever is needed — during a single operation.
What to Expect
Consultation & Evaluation
Dr. Kashani will review your complete history — the year of your vasectomy, your current health, your partner's fertility status, and your goals. He will give you an honest, individualized assessment of your chances of success and discuss whether reversal or assisted reproduction (IVF with sperm retrieval) is the better path for your situation.
The Procedure
Vasectomy reversal is performed as an outpatient surgery under general or spinal anesthesia. The procedure takes 2 to 4 hours depending on which technique is required. Dr. Kashani uses an operating microscope and microsurgical instruments to achieve the finest possible reconnection. You go home the same day.
Recovery
Expect scrotal swelling, bruising, and soreness for ~2 weeks. Most men return to desk work within 7 days and resume light physical activity within 2 weeks. Sexual activity and ejaculation should be avoided for 3 weeks to allow healing. A supportive undergarment is worn for ~2 weeks.
Monitoring — Semen Analysis
The first semen analysis is performed about 6 to 8 weeks after surgery to check for the return of sperm. Follow-up analyses are done every 2 to 3 months until pregnancy is achieved or sperm counts stabilize. Sperm typically return within 3 to 6 months after vasovasostomy and 6 to 12 months after vasoepididymostomy.
Frequently Asked Questions
How do I know if reversal is right for me vs. IVF?
Both paths lead to similar pregnancy rates — the choice comes down to your situation. Reversal is often the better first step: a single procedure restores the chance of natural conception month after month, and it's usually more cost-effective when insurance doesn't cover IVF. IVF with sperm retrieval tends to be favored when the female partner has a fertility concern, when she's over 35 and time matters (pregnancy arrives faster with IVF — roughly 8 months versus 16 with reversal), or when the vasectomy was performed very long ago. There is no strict age cutoff — it depends on ovarian reserve and how soon you'd like to conceive. Some couples do both: a reversal with sperm frozen as backup during the same procedure. Dr. Kashani will walk you through both options honestly at your consultation.
What are my success rates based on how long ago I had my vasectomy?
Success is measured two ways: sperm returning to the ejaculate, and pregnancy. In the largest published series — over 1,200 microsurgical reversals — the results by time since vasectomy were: under 3 years, 97% sperm return and 76% pregnancy; 3–8 years, 88% and 53%; 9–14 years, 79% and 44%; 15 years or more, 71% and 30%. A longer interval doesn’t rule out success — modern microsurgical techniques achieve good results even after 10+ years. Across modern microsurgical series, roughly 9 in 10 men regain sperm and about 7 in 10 couples conceive. Pregnancy rates run lower than sperm-return rates mostly because of female partner factors — above all, age. Dr. Kashani will give you a realistic, individualized estimate at your consultation. (Figures: Belker et al., Journal of Urology, 1991; Herrel et al., Urology, 2015.)
Is vasectomy reversal painful?
The surgery itself is performed under anesthesia so there is no pain during the procedure. Post-operative discomfort is moderate — most men describe it as similar to the soreness after the original vasectomy, but lasting a bit longer. Pain medication and scrotal support manage this well. Most men are comfortable within 1 to 2 weeks.
What if the reversal doesn't work?
If sperm don't return after reversal, the next step is surgical sperm retrieval combined with IVF/ICSI. This bypasses the reconstruction entirely — sperm are collected directly and used to fertilize eggs in the lab. Retrieval is highly reliable in this situation and ICSI outcomes are strong; the main factor in success is the female partner's age and fertility. Sperm can also be frozen during the original reversal as a backup, so a second procedure may not even be needed. Dr. Kashani will discuss every contingency with you before surgery — you'll never be out of options.
How much does a vasectomy reversal cost?
There is no single price — it varies by surgeon, region, surgical facility, anesthesia, and whether a more complex reconstruction is needed. Ask for a written, all-in estimate covering the consultation, surgeon, facility, anesthesia, medications, and follow-up semen analyses so there are no surprises.
Does insurance cover vasectomy reversal?
Often not — reversal is frequently classified as elective fertility treatment and excluded from coverage. Our office will run it through your insurance to confirm your specific coverage.
Why Choose Dr. Kashani for Vasectomy Reversal?
Vasectomy reversal is one of the most technically demanding procedures in urology — it requires microsurgical training, a high-powered operating microscope, and the ability to perform both vasovasostomy and vasoepididymostomy in a single operation. Not every urologist has this training.
Dr. Kashani completed his fellowship in Male Sexual Health and Reproductive Medicine at Lenox Hill Hospital in New York City — one of the premier programs in the country for male reproductive surgery.
- Fellowship-trained in microsurgical vasectomy reversal
- Performs both vasovasostomy and vasoepididymostomy
- Honest guidance on reversal vs. IVF decision
- Private, discreet, judgment-free environment
- Two convenient Long Island locations
- Same-week consultation appointments available
Ready to Explore Your Options?
Dr. Kashani offers thorough, honest consultations for vasectomy reversal at two Long Island locations. The first step is simply a conversation.