You and your partner are raising a happy house filled with children, and the idea of getting pregnant again doesn’t make fiscal sense right now. Or maybe your sex life is off-the-charts hot and you can’t imagine how your explosive bedroom behavior isn’t going to result in two blue lines one of these days — even though you’re using condoms and birth control pills because you are determinedly child-free. Whatever your reason for exploring one of the most no-nonsense contraceptive procedures of them all — we’re talking vasectomy — there are a few facts you need to know before booking your husband or boyfriend’s doctor’s appointment and then surprising him over breakfast (kidding).
Although there is still research being done on male birth control pills, a vasectomy is the most common and scientifically proven male sterilization procedure, with about 500,000 being performed in the United States each year, according to Dr. Philip Werthman, urologist and director of the Center for Male Reproductive Medicine and Vasectomy Reversal in Los Angeles. But just as there is more than one women’s birth control pill on the market, Werthman says all vasectomies are not the same and all vasectomy doctors are not the same.
A vasectomy is a surgical procedure that blocks both sperm ducts, which are called the vas deferens. Naturally, few men want to imagine a scalpel within 10 feet of their penises or testicles, which is why it’s important to debunk the first vasectomy myth: Not all procedures require a scalpel or even a needle. Using local anesthesia (which is pressure-injected through the skin and the vas and not the testicle), Werthman says no cut is made and no stitches are necessary. The procedure is performed through a small perforation, takes about 10 minutes to complete and men are encouraged to recover by staying off their feet for 24 hours and not ejaculating, engaging in heavy-lifting, swimming, bathing or playing golf for one week.
Now, here’s where things get tricky. The act of blocking the sperm ducts doesn’t automatically make a man infertile. You can still get pregnant — even three months after a vasectomy — and following up with a doctor after the procedure is a must.
“Sperm live in the reproductive tract upstream from where the vasectomy is performed and it can take from six weeks to three months for these sperm to be flushed out of the system or die off,” Werthman says. “We recommend that you have a minimum of two semen analyses starting around six weeks after the vasectomy or after 20 ejaculations. You must have two consecutive semen analyses that show no sperm in order to be considered sterile and you must use some form of birth control until that time.”
You’ve probably heard about a vasectomy reversal, called a vasovasostomy, and maybe even thought: Great! If we ever want more kids, we’ll just head right over to the doctor’s office again. No big deal. Well, yes and no. A vasectomy reversal is an outpatient procedure that restores the free flow of sperm, and it’s one that Werthman says is highly successful when performed by an experienced male infertility microsurgeon. But it’s important that you choose your specialist with great care.
“Unfortunately, other doctors without these special skills will often attempt to perform the surgery themselves, rather than referring the patient to a male infertility specialist,” Werthman says. “To have your best chance for success, you should see a specialist.”
The closer your partner is to the time of his vasectomy, the easier it will be for a surgeon to reverse it, though Werthman says in hands of a skilled microsurgical specialist who is experienced in vasectomy reversal, even men who have waited 15 years and longer since their vasectomies can enjoy a complete reversal and fatherhood.
If you’re worried about your chances of getting pregnant in the future, Werthman says some men choose to have their sperm frozen and stored just in case they change their minds and want more children in the future. “Having frozen sperm would mean that they would not necessarily need a vasectomy reversal or have to do in-vitro fertilization, both of which can be costly,” he says.
And, as with any medical procedure, there are risks to keep in mind before getting a vasectomy.
Complications are rare when a no-scalpel vasectomy is performed, Werthman says, but can include pain, bleeding, swelling or infection, failure of the procedure, sperm granuloma formation, injury to the blood supply of the testicle resulting in the testicle getting smaller (atrophy) and chronic testicular or epididymal pain (post-vasectomy pain syndrome).
The more we can understand all aspects of procedures like vasectomies, the better our chances of choosing the right contraceptive method for ourselves and our partner.