Deciding if vasectomy is right for you

What if I change my mind in years to come? Is it reversible?

Vasectomy should not be considered contraception - it is sterilization, and should be regarded as permanent. If you think you might change your mind later, or are not totally sure you want to be sterilized, you should think about different methods of birth control. Reversal with restoration of fertility is possible, but becomes less likely as the years go on. In any case, the operation to reverse a vasectomy is expensive, reversal with restoration of fertility is uncertain, and becomes even less certain the longer after your vasectomy it is done.

Source of information on reversal are our medical journals section. We also have a page of links to reversal information and specialists, and the advice from the newsgroup section mentions doubts about being sterile.

Sperm freezing is also an option, but this is expensive to store and use (by IVF), and deteriorates over time in any case. www.spermbankdirectory.com has a good FAQ about sperm banking and donation, and a directory to pick a local one. The medical profession will tell you to consider it permanent.

I'm not sure I want to have a vasectomy - should I go ahead anyway?

Once again, vasectomy should not be considered contraception - it is permanent sterilization. It's fair to say that being nervous and last minute jitters are perfectly normal, but if you have serious doubts or you are not sure, it is better to wait until these issues have been resolved. It's a good idea to talk through your doubts with your partner and your doctor. Also some organizations such as Planned Parenthood and Marie Stopes International provide counselling services. Engender health has a discussion on the topic, and it's discussed in our advice from the newsgroup section.

I'm getting pressurised into having it done - should I go along with it for a quiet life?

The decision to have a vasectomy affects both people in a couple. Therefore to some extent it will naturally be a joint decision. However, at the end of the day, it is something you need to be sure that you want to have done. Statistically, the men who regret vasectomy least are those where the couple both attended the counselling session, and it's a considered decision not made under pressure. The men who have been forced into vasectomy often regret the decision. It's a common reason for reversal, and those who have psychological/sexual difficulties after vasectomy are most often the ones forced into having it done.

I've got existing problems "Down there" - will a vasectomy make things worse?

Post vasectomy pain syndrome (PVP) can be caused by undiagnosed problems that existed before the vasectomy. So yes, a vasectomy may make an existing problem worse. If you have certain conditions, vasectomy should be delayed until the problem is resolved. E.G, local or acute systemic infection, signs or symptoms of sexually transmitted disease, filariasis, elephantisis, intrascrotal mass (lumps in your scrotum) or hypersensitivity to the anaesthetic agents to be used. Some conditions may increase the risks, or make the operation difficult. E.G, previous scrotal trauma, large varicocele or hydracele, previous surgery for cryptorchidism, inguinal hernia, and some blood coagulation disorders. Any problem should be checked out by your doctor, and you should mention any pains or abnormalities to the doctor, and discuss if a vasectomy is going to make things worse during your consultation.

My wife is of the age when the menopause is looming in a few years. Should I have a vasectomy?

Nobody can advise you what do on this question, or predict the future. When women cease to be fertile isn't set in stone - it can be very early, or very late. However, the question is certainly something to bear in mind when considering vasectomy.

When I told my male friends I was considering a vasectomy they thought I was mad - is this the usual reaction?

Depends on the age, marital status and how many kids they have! The two usual misconceptions about vasectomy are that you shoot nothing on ejaculation, and your hormones change with a loss of masculinity. Both are not the case. You still ejaculate 97% (approx.) of what you did prior to vasectomy, and you still produce testosterone.

These misconceptions are common. A study published in 2003 found that only 26% of men could identify what happened in a vasectomy. 22% either didn't know, or thought that vasectomy stopped you ejaculating, and 20% either didn't know or thought that vasectomy gave you a higher voice!!

Many men have these misconceptions until they reach the point in their lives where they start considering and researching a permanent birth control solution, hence the misunderstandings. Most young and single men will give you this reaction, but older men or men who have had a vasectomy already will react differently. You will probably find more vasectomised men amongst your circle of friends, colleagues and family than you think!

Will my new girlfriend believe I've had a vasectomy and not insist on a condom?

Female posters have usually answered this question by saying that even if they did believe that particular statement, they would still insist on a condom being worn for protection. You should also think about protecting yourself. Having a vasectomy isn't going to give you a licence to have unprotected sex in casual relationships.

My new partner says he's had a vasectomy so there's no need to use a condom - is it possible to see a scar?

Firstly, there is the issue of sexually transmitted diseases to think of. Secondly, the only way to tell if he is sterile is by a sperm test. The incision is usually very small, the scrotum skin tends to be wrinkly and hairy, so seeing a scar will be very difficult. It may be possible to see the scar if you know where the incision was, and you are examining the site closely with a good light! We have a page that has some photographs of vasectomy scars after healing.

I'm young, single and childfree - can I get a vasectomy?

This question is asked surprisingly often in ALT.SUPPORT.VASECTOMY. Posters generally report that the doctors reaction is usually favourable if approached in the right way. If you have a well thought out strategy, and can answer the doctors concerns then there seems to be little problem. In the UK vasectomies for childfree are rare on the NHS, but can often be done privately. Childfree page

I've heard vasectomy is illegal in France - what's the situation here?

It was until June 2001 under the Napoleonic code. However, the law has changed. We have a discussion on the situation that includes links in French.

How do I go about organizing a vasectomy?

Most of us went to our own or family doctor, who asked a few questions and did a physical check. The doctor then referred us to a surgeon or urologist for the procedure. It may be that you don't want to go to your doctor - if so other organizations exist. Family planning clinics, community providers etc. Some men go to a urologist direct, but a good place to start is your own doctor. We have a page that has men's experiences organising vasectomy, and our links section has sections on finding a doctor in your area, and how to check his qualifications.

When should I schedule it?

This question is more important than people sometimes think. Example:- If you are a cyclist, then it's likely you will want to do a lot of cycling from spring onwards, therefore scheduling the vasectomy for the winter will allow you time to heal, without disturbing your hobby. Similarly, you might want to consider when it's most convenient/inconvenient to fit in with work etc.

How much does it cost?

In the US most health insurance plans cover the cost of vasectomy, but a guideline price for the simple out-patient procedure is around $300-$1000. In countries where a National Health Service operates, usually it's done under that scheme free. However, the option does exist of paying privately and avoiding waiting lists. Typical costs were around £400 in the UK for a vasectomy. Reversal is much more expensive, with prices starting at $5000 in the US and £3500 in the UK. The costs quoted were the typical prices from a sample of practitioners internet adverts at the end of February 2004.

Can I check out the Doctor's qualifications and licence to practice?

On the links page we have a section of URL's where you can check these facts out with the relevant medical boards. So far we have The UK, USA, Australia and New Zealand. If you find any more please let us know!

Surveys, studies and statistics - what do all they mean?

You are bound to come across a lot of statistical "information" whilst doing any form of research on the web. Please remember that no matter where a statistic is quoted, the quote can be misleading. It's commonplace to see a banner headline quoting a percentage, and upon further examination of the numbers involved a totally different picture emerges. My advice when reading studies and articles is to remain critical (even cynical!) at all times, and make sure that the headline *is* a true encapsulation of the article that follows!

Although I personally give all articles a thorough read through with a practiced eye, I have three basic rules that prompt deeper investigation:-
1. If the survey response rate is nearer to zero than 100%
2. If the study conclusions are based on less men than I have fingers and toes
3. If the survey results are ONLY quoting percentages and no raw data numbers

The following chapters from "Science Without Sense - The Risky Business of Public Health Research" by Steven Milloy explain how statistics are arrived at, and common techniques for "Massaging them" to fit.

I've booked an appointment for a consultation, but the doctor has asked me to bring my wife - why?

The reasoning behind this is unfortunately never clearly explained. It clearly applies only to couples, and not single men. In a couple, the decision to have a vasectomy affects both partners, so logically both should be involved with the discussion. Satisfaction with vasectomy research clearly shows that where men who have had good counselling, and the couple have been involved with the decision, regret and requests for reversal later are much rarer. Unfortunately, this is not explained, and tends to come across as "You can't have a vasectomy without your wife's signature" - which isn't the case!

Joint counselling isn't a legal requirement anywhere to my knowledge, but many doctors prefer joint counselling for the reasons above.

It should be made clear that to my knowledge no laws exist anywhere requiring a wife's consent for the husbands vasectomy. What can happen, is that there is one form to acknowledge both receipt of counselling, and consent for the operation that both are asked to sign. It would be better in my opinion to have one form for the counselling signed by both, and a separate one for the procedure signed only by the man.