What to know: Things to consider before getting a vasectomy

A vasectomy is a big, life-altering decision and shouldn’t be made lightly. As part of the decision-making process, it’s a good idea to discuss all the available birth control options, and the pros and cons of all methods to work out which one is the most suitable for you and your partner. Vasectomy isn’t the right choice for everybody. It’s not a temporary method of birth control, it should be considered permanent sterilization, and you need to be sure you are happy with this.

The Decision

Everyone is different; therefore, everyone will take different things into consideration when deciding if a vasectomy is the right option for them. Common considerations are:

• What happens if a death occurs, and I want to be able to father more children?
• What happens if we split up, and I want to start a family with a new partner?
• What happens if I just change my mind in years to come, or my personal situation changes?

There are many other questions we ask ourselves, but these are the usual type of questions we need resolving before we can be happy about the decision. All methods of birth control have risks, vasectomy included. To make an informed decision, you need to research the risks of all methods of birth control and perform a risk assessment for each method based on your individual circumstances, then work out which method represents the lowest overall risk to you as a couple.

The reason 90% of men request a reversal is a change in marital status.¹ Also, another high-risk category is young men under 30 who have many life changes and choices ahead. Men who had a vasectomy in their 20’s are 12.5 times more likely to have a reversal than men who have a vasectomy aged 35+.²

What age is too young for a vasectomy?

Men with kids don’t usually have a problem getting a doctor to perform a vasectomy, but younger men who are childfree often encounter doctors that are unwilling and unhelpful. While the laws governing minimum vasectomy age will vary depending on country and jurisdiction, in the United States, any man who is over 18 years of age and mentally sound can have a vasectomy.

Doubts about permanent sterility

If you are having doubts about this choice, you should share your concerns with your doctor, and perhaps reconsider vasectomy as a birth control option. If you express any doubt, the doctor will often suggest you wait until you are happy to be sterile, as vasectomy is permanent sterilization – not a temporary contraceptive method.

Do men ever regret having had it done?

The satisfaction with the procedure is generally high³, but in some cases, men do have vasectomies and are unhappy. The chief causes of regret are: 

• The results of an ill-considered decision (often due to making the decision under pressure)
• Changes in circumstances some years later (such as the death of a child or remarriage)
• Post-vasectomy pain syndrome (PVPS)

It’s worth adding that satisfaction rates are highest amongst men who were the ones who suggested vasectomy first.

I’m not sure I want to have a vasectomy – should I go ahead anyway?

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 provide counseling services.

I’m getting pressured 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 counseling session, and it’s a considered decision not made under pressure. Men who have been forced into vasectomy more 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.

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 the 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 the restoration of fertility is uncertain, and becomes even less certain the longer after your vasectomy it is done. Sperm freezing is also an option, but this is expensive to store and use (by IVF) and is less successful over time in any case.

Choosing a doctor for a vasectomy

We have a couple of suggestions on how to find a reputable urologist in your area.

• Primary care doctor: Ask your primary care doctor for a referral. Primary care providers often refer patients to specialists and are a good source for finding a qualified urologist.
• Insurance company: If you have health insurance, get in touch with them and ask for a list of certified urologists in your area who participate in their health plan. Most insurance companies cover the cost of a vasectomy.
• Friends and family: Look for word of mouth recommendations. If you know anyone who has had a vasectomy, ask about their experience with their urologist.

Once you’ve created a list of potential specialists for your vasectomy, research their credentials and experience. The internet offers a wealth of information on medical professionals, take some time to read testimonials and reviews on various websites. Once you’ve made a decision, schedule a consultation. A consultation is your opportunity to confirm in detail how you will be treated during your vasectomy and what you can expect afterward. Keep in mind that if at any point, you are not satisfied with what you are hearing, you can cancel the procedure to seek out a different doctor.

When should I schedule it?

This question is more important than people sometimes think. For 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 more 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.

Summary

Ultimately, choosing to be sterilized should be a decision you are happy with, in the long term. In circumstances where undue pressure is being applied, it’s a good idea to delay having the procedure until you have had the opportunity to discuss all the implications fully with your wife/partner and are happy about going ahead.