Male vasectomy procedure: what is a vasectomy?

Vasectomy is a simple surgical procedure that a man can have as a permanent form of birth control. It works by cutting off the supply of sperm to your semen so that even though you still ejaculate normally, there are no sperm present and so you cannot make someone pregnant. Because of its permanent nature, you should think long and hard before having a vasectomy procedure, and be really certain that you will never want to father a child from now on.

We can understand that there are fears around the effects that a vasectomy may have. In this IVI blog article, we aim to give you all the information you may need. What is the vasectomy procedure, how much is a vasectomy, are there any risks and is a reversal possible? Here’s everything you need to know.

Why have a vasectomy?

Men who choose to have a vasectomy do so because it is a safe and very effective form of contraception. About three months following the vasectomy procedure, you can be confident that you have an almost 100% effective form of birth control. In addition:

• It can be performed as an outpatient procedure with very little inconvenience and a low risk of complications.
• The cost of a vasectomy is a lot less than the female equivalent, tubal ligation or ‘having your tubes tied’, and also significantly less than the long-term cost of birth control medication for women.
• Vasectomy means no longer having to take steps for birth control, such as a condom, at the time of having sex. However, protection against sexually transmitted diseases remains still essential.

What is the vasectomy procedure?

The vasectomy procedure involves severing or sealing the vas deferens, the two tubes that carry sperm from the testicles to the urethra. Your testicles will continue to produce sperm, which will be harmlessly reabsorbed by the body, but they won’t get into your semen. There are two ways of carrying out a vasectomy. In both, you will be given a local anaesthetic so although you will be awake, it will not be painful.

Incision vasectomy

Two small cuts are made in the skin of your scrotum and through these the vas deferens tubes are located. Sometimes a small section of the tube is removed completely and the ends cauterised, or they may be tied or blocked off with surgical clips. The entire operation takes around 20 minutes.

No-scalpel vasectomy

In the no-scalpel version of a vasectomy, the only difference is that no incision is made in your skin. There is just a small puncture hole through which the tubes are reached. They are then blocked in the same way as for an incision vasectomy. The result is the same, but the small puncture is quicker to heal and there is no scarring.

How much is a vasectomy?

Currently there is no Europe-wide standard on the cost of a vasectomy or whether it may be available free of charge in some circumstances. Patients who want to discuss having a vasectomy should first contact their primary healthcare provider, who will be able to offer information on local urology clinics. Alternatively, there is a whole range of urology clinics where patients can self-refer. These are likely to publish estimates of their prices in advance, so that you can get a good idea of what to expect before you go ahead.

Are there any risks in having a vasectomy?

No surgery is completely without risk, but the risks in having a vasectomy are very low. If there are any aftereffects at all, these are usually mild and short-lived. They can include:

• Bleeding or a blood clot in your scrotum, or blood in your semen;
• Bruising or swelling of your scrotum;
• Infection at the site of the surgery;
• Mild discomfort or pain.

Although risks are minimal, you should keep in mind that having a vasectomy does not give you any protection from sexually transmitted diseases. That is why using a condom is still the best protection in this regard. There are also many urban myths surrounding the subject of vasectomy. An increased risk of heart attack or some cancers, severe pain, or damage to the sexual organs, or reduced sexual drive or performance, are some of them. All of these are unfounded and researchers have found no evidence to support them.

The main risk of having a vasectomy is that you will change your mind later and want to father a child.

Is vasectomy reversal possible?

Vasectomy reversal is possible but it is a lot more complicated than the original vasectomy procedure. It needs to be carried out under general anaesthetic in an operation which lasts between two and four hours. There is no guarantee that a vasectomy reversal will be successful either. Success is estimated to be around 75% if you have it reversed within three years. It declines to around 40% to 45% after 10 years and only 10% after 20 years. If you have changed your mind and want to father a child, IVF with sperm retrieval could be a better option and offers a higher rate of success.

IVF with sperm retrieval

Surgical sperm extraction is a well-established technique in fertility treatments. It’s recommended for men who have no sperm in their semen for a variety of reasons, including those who have had a vasectomy. This is what happens:

• Sperm is collected from the testicles or testicular tissue by means of surgery. There are various ways of achieving this, some carried out under local anaesthetic and some requiring general anaesthesia.
• Since there will be a comparatively small amount of sperm, it will need to be prepared in the laboratory to optimise fertility.
• When the female partner’s eggs are retrieved following the standard IVF ovarian stimulation process, fertilisation takes place in the laboratory, probably using the ICSI technique in which a single healthy sperm is selected and microinjected directly into each egg.
• Selection of the best quality embryo and transfer to the maternal uterus then follows as part of the normal in vitro fertilisation process.

Talking about fertility with IVI

If you or your partner have had a vasectomy and then a change of heart, you don’t need to give up on your dream of starting or completing your family. Get in touch with us at IVI using our online contact form and we can explore your options for fertility treatment.