Fertility Restoration After Vasectomy: AUA Guideline (2026) Part II

This Guideline aims to provide a contemporary overview of options for future fertility following vasectomy. See Part I of this series for information on indications for vasectomy, pre-operative counseling and preparation, peri-operative considerations, procedural techniques, potential risks and complications, and post-operative care.

A comprehensive search of the literature was performed and covered articles published between January 1, 1990 and January 30, 2024. Relevant study designs included randomized controlled trials, controlled clinical trials, and observational studies (cohort with and without comparison group, case-control). Systematic reviews were searched for as an additional resource to identify any relevant studies with the designs noted above that may not have been captured in the literature search.

The Panel developed evidence- and consensus-based statements based on a comprehensive systematic review of the literature. Recommendations for restoration of fertility following vasectomy are detailed herein.

While this Guideline provides a summary of the current evidence related to vasectomy reversal and other fertility options after vasectomy, future review will be required as knowledge in this space continues to evolve. The unabridged version of this Guideline is available at auanet.org.