Vasectomy and Vasovasostomy - Considerations

Highlights	Surgery	Reversal Surgery
Introduction	Complications	Assisted Reproductive Technologies
Considerations	Unexpected Pregnancy	Resources
Male Contraception	Long-Term Complications	References

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Considerations

Having a vasectomy is a serious decision. The surgery is intended to be permanent. The great majority of men who seek a vasectomy have been married for ten years or more. Not all are good candidates, however. It is important that both the woman and the man completely agree that they no longer want to have children. They should also agree that permanent birth control is the right decision for them. Ideally, the couple should view the operation as a mutual commitment to an already successful marriage or relationship. Vasectomy generally is not a good idea if the couple''s relationship is under great stress; it is not a cure for emotional or sexual problems between a man and woman.

After deciding that permanent birth control is the best solution, a couple still has the option of either vasectomy for the male, or tubal ligation for the female.

Still studies indicate that between 5 -11% of men who have vasectomies regret the decision. In fact, in a 2001 study, 56% of men seeking treatment for fertility were hoping to reverse their vasectomies. Thirty years ago, this percentage was only 5%.

A reversal procedure called vasovasostomy is available, but it is a major operation that provides no guarantee of restored fertility. In a 2000 Australian study of procedures performed between 1980 and 1996, vasectomy rates had leveled off but vasovasostomy rates had increased in men by nearly 70% in the most recent 5-year period compared to the earliest 5-year period.

Good and Poor Candidates for Vasectomy

Vasectomies may be right for the following:

Men in relationships in which both partners agree they have all the children they want and both do not want to use or are unable to use other methods of contraception.
Men in relationships whose partners have health problems that make pregnancy unsafe.
Men in relationships in which one or both have genetic disorders that they do not want to transmit.

Vasectomies may not be right for the following:

Men in relationships in which one partner is unsure about his or her desire to have children in the future. (Couples in which the woman is working when they make the decision are at particular risk for regretting the decision later on.)
Men whose current relationships are unstable, going through a stressful phase, or are marked by substantial conflict.
Men who are considering the operation just to please their partners.
Men who are counting on having children later by storing sperm or by surgical reversal of the vasectomy.
Young men, who still have many life changes ahead.
Men who are single (including those divorced or separated) at the time of vasectomy.
Men who are having the operation primarily for the sake of their partners and not wholly for their own reasons.
Men or couples whose only motive is freedom from distraction imposed by other contraceptive methods during sexual activity.