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What You Need to Know Before Getting a Vasectomy

A vasectomy is a safe and effective form of family planning, but is it right for you?

doctor with patient in medical office
A vasectomy is considered a form of sterilization, therefore it should be thought through before making the official decision.
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The Supreme Court's decision to overturn Roe v. Wade has everyone questioning the ways it will affect our health care and the consequences one would face for seeking abortion services online. One of the most researched topics brought on by this ruling were vasectomies. A vasectomy is a sterilization procedure that prevents sperm from leaving the body in order to ward off a pregnancy.

If you've expressed interest in having this procedure done, it's important to consider some factors before getting one. As with any medical decision, you should discuss it with a primary care doctor or urologist to make sure it's the best option for you. Vasectomies are overall considered a safe operation, but since it's a permanent form of birth control it isn't necessarily right for everyone. Still curious? Keep reading to learn more about vasectomies and if you're the right candidate for one.

How does a vasectomy work?

Doctor holding a scalpel in a doctor's office

There are two types of vasectomies: the incision method, and the no-scalpel method. 

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A vasectomy is a permanent minimally invasive procedure for sterilization. It's done by cutting the tubes connected to the testicles, known as the vas deferens, which carry the sperm. A vasectomy blocks sperm from being released into the semen. The contraceptive method is considered to be 99.9% effective at preventing pregnancies. 

Dr. Stanton Honig, a urologist and director of the Yale Medicine Male Reproductive Health/Sexual Medicine Program, explains that it is a safe and effective procedure. "A vasectomy is generally done in your doctor's office under local anesthesia and only takes 15 minutes," he says. There are two types of vasectomies: the incision method and the no-scalpel method. The incision method is done using a scalpel to make one or two small cuts in the skin of the scrotum. Through these cuts, the vas deferens are located, also cut and their ends are sealed off by getting tied or using an electrical current known as cauterization, followed by a single stitch to the skin to close up the incision. 

The no-scalpel method makes a small puncture in the scrotum using a hemostat (a forceps-like instrument) instead of using a scalpel. This is the preferred method because it seals the vas deferens the same way as the incision method, but it doesn't require stitches and reduces the chances of excessive bleeding, infections or other complications. 

As far as the healing process goes, Honig says healing is quick enough that you can be cleared to exercise two weeks after the procedure. Pain medicine provided after the procedure is typically non-steroidal anti-inflammatory drugs (NSAIDs), such as Tylenol or Advil.

In rare circumstances, there may be a small risk of bleeding and infection and long term mild pain. But Honig insists that risks are minimal and says, "There are no long term effects on general health in men who have had a vasectomy." And in case you're wondering, there is no negative effect on your sexual performance either. Honig remarks, "in fact, sometimes things get better since the anxiety of an unwanted pregnancy is removed from the scenario."

Bear in mind a vasectomy isn't officially cleared until three months later when a patient gets a semen analysis done. Patients are asked to use other forms of contraception until they can confirm that their vasectomy was successful. "Once a patient does a semen analysis that shows either no sperm or less than 100,000 non-mobile sperm in the ejaculate, the chance of pregnancy is still 1 out of 2000," says Honig. 

How much does a vasectomy cost?

Middle aged man reading his medical bills

Health insurance typically helps cover the cost of a vasectomy. 

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Most vasectomies are covered by your health insurance and according to Planned Parenthood can cost up to $1,000, depending on the type of vasectomy you receive and where you get it done. "It's cheaper to have a vasectomy than for insurance carriers to pay for costs of another pregnancy and a new family member," explains Honig. 

Compared to the alternative option of women having to get a tubal ligation (when the fallopian tubes are sealed up), a vasectomy is just as effective, cheaper, less invasive and the recovery time is faster. "Many men feel that this is their turn to help out with family planning," observes Honig.

Who should get a vasectomy?

family of four sitting on porch

Men who get vasectomies are usually married fathers who are done procreating.

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Honig says people who opt to have vasectomies are usually married and do it once they are done having children. A 2018 study showed that the average age men get vasectomies are 36 in rural areas and 37 in larger cities. These men also tend to have one to three children when they make the decision to get the procedure done. More recent research by the American Journal of Men's Health shows that the average age range of men who get vasectomies is between 30 and 56 years old. Additionally, 90% of men who get the procedure done are white and married with children. 

Honig warns that it's important not to take a vasectomy lightly. If you choose to get it done, you should be 100% certain you are done having children. "Regret is higher in men who do not have children, especially those who are very young," he says. Instead he thinks a better approach for younger men inquiring about vasectomies is to opt for other non-permanent options, such as using contraceptives.

Can a vasectomy be reversed?

middle aged man waiting in doctor's office

Vasectomies are reversible, but it can be expensive and require a hospital visit. 

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The good news is vasectomies can be reversible and generally have a 50% to 70% success rate if, later in life, you decide you want a child (or more children). However, it is important to keep a specific time frame in mind if you do choose to reverse it. "The success rate is usually better if the patient is less than 10 years out from the vasectomy," explains Honig, but he says it can still be successful in patients who are further out as well. 

As an alternative (instead of a reversal), Honig suggests a sperm retrieval that is combined with in vitro fertilization and intracytoplasmic sperm injection (ICSI), when a single sperm is injected directly into the cytoplasm of the egg for fertilization.

"Patients should research who has extensive microsurgical experience with vasectomy reversals in their area to get the best results," he advises. An important thing to keep in mind is that a vasectomy reversal is more expensive and complicated than getting one done. It's performed in a hospital and needs to be done by a doctor experienced in microsurgical techniques and can take up to four hours. Insurance companies usually don't cover the cost, which means you will have to pay out of pocket for a procedure that can cost thousands of dollars. This depends on your location and where you have it done, so it requires extensive research to get the best treatment. 

Bottom line

As with any permanent procedure, you should weigh the pros and cons before getting a vasectomy. If you're finished having children chances are this is a better option for you than if you haven't started yet and may have a change of heart down the line. If later on you decide on a reversal, it's important to do your research to make sure you're getting the most qualified doctor who can provide the best experience. It's also an investment, so it's important to consider your financial standing and if you'll be able to cover the cost. 

Hence, why it's important to be certain that a vasectomy is something you want done permanently. Regardless, it's a helpful option to have on the table if you're looking for a definitive birth control solution that doesn't break the bank or negatively impact your health. 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.