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November 21, 2014

How can you tell if a man has had a vasectomy?

When a woman begins seeing a man who claims to have had a vasectomy, she may wish to verify this by looking for a scar or other evidence of the procedure.

It’s natural to assume that locating an incision or detecting abnormalities in a man’s ejaculatory fluid can provide clues as to whether a man has had a vasectomy. In reality, finding physical proof of a vasectomy is extremely difficult.

This article discusses the changes that a man experiences (or doesn’t experience) after a vasectomy, but the bottom line is that the only way to tell if a man has had a vasectomy is with a sperm count performed by a qualified lab.

Vasectomy scarring

A vasectomy does indeed leave one or more scars, but they are often very small and can be nearly impossible to see once the incisions have fully healed.

Further complicating things is that fact that a man’s scrotal skin is wrinkly and often covered with hair. As the scar fades over time it can easily blend in to the natural bumps and creases of his anatomy.

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Even under ideal examination conditions it can be very difficult to locate a man’s vasectomy scar, which means spotting evidence of a vasectomy can be nearly impossible during normal couple interactions. A quick visit to our vasectomy pictures section (NSFW) will demonstrate how hard it can be to see a fully healed vasectomy scar.

This means that simply looking for a scar is not a reliable way to verify if a man has had a vasectomy.

The different kinds of vasectomy scarring

Many people don’t realize that doctors use several different methods to perform vasectomies. These varying techniques leave scars in different locations, and the scars can be more or less noticeable depending on the method.

Traditional vasectomies involve making two incisions along either side of the scrotum. These incisions are small, and their position will vary depending on the doctor performing the procedure. The scars caused by this type of operation are probably the easiest to spot of all the different vasectomy methods, but over time the scars will fade and become more difficult to see.

Some doctors perform a vasectomy with a single incision along the midline or “seam” of the scrotum, also known as the raphe. Since the scars left by this type of vasectomy fall on the scrotum’s central ridge, they are practically invisible once healed.

Another popular technique is known as the no-scalpel vasectomy. This operation is performed with a sharp pair of forceps that puncture the scrotal skin rather than slicing it open. This form of vasectomy leaves almost no visible scarring once healed.

Changes in ejaculate

While the composition of a man’s ejaculate will change after a vasectomy, it is more or less impossible to notice the difference through sight, touch, taste, etc.

The only change in a man’s semen after a vasectomy is the lack of sperm. Since sperm account for no more than 2% to 5% of the total volume of a man’s ejaculate, this change is not noticeable under casual circumstances.

Semen analysis is the only way to tell

The only way to be 100% certain a man has had a successful vasectomy is by having a semen analysis performed by a laboratory.

A lab-verified sperm count of zero means the man is not fertile and has definitely had a vasectomy. A non-zero result means one of two things:

  1. The man did not have a vasectomy.
  2. The man had a vasectomy, but it failed.

A surprisingly large percentage of men (40% to 50%) never return for a post-vasectomy sperm count. Without the “all clear” from the doctor it’s impossible to be sure that the operation was a success.

The risks of vasectomy failure

Although uncommon, it is possible for vasectomies to fail.

If a man can produce evidence of a sperm count or if you trust that he has done the necessary follow up testing, then this may be sufficient. However, it is still possible for a vasectomy to fail years after the operation, which is why an current sperm count is a good idea.

As mentioned previously, many men never go back for a post-vasectomy semen analysis. While the success rates of vasectomy are very high, there’s simply no way to be sure until the sperm count results are in.

Another issue is that vasectomies can naturally reverse themselves through a process known as recanalization. Recanalization allows sperm to travel between the cut ends of the vas deferens (sperm tubes), although the sperm count is often greatly reduced from pre-vasectomy levels.

Vasectomy failure is very uncommon, but unless a man has had a relatively recent test verifying his sperm count is zero there is an outside chance he can still father a child.

For more on this topic, see our articles on pregnancy after vasectomy and vasectomy failure rates.

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