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Male Sterilization (Vasectomy)

Male sterilization, also known as a vasectomy, is a permanent method of contraception. This means that once you’ve undergone the procedure, you won’t be able to get anyone pregnant naturally anymore for the rest of your life.



This article is part of our Contraception Series!

 

What we're covering


What is it?

How does it work?

How effective is it?

What side-effects could I get?

When can't I use it?

Does it work immediately?

What happens to my fertility if I stop?

Does it protect against STDs?

 

Note: the information below was sourced from references (1-5), unless stated otherwise.


What is it?

Male sterilization, also known as a vasectomy, is a permanent method of contraception. This means that once you’ve undergone the procedure, you won’t be able to get anyone pregnant naturally anymore for the rest of your life. Because this is, in principle, irreversible, you need to be sure that you won’t want biological children in the future. Be aware that you might come to regret your decision, especially if you’re young (6-8). This does not mean you shouldn’t do it; it just means you have to think about it very well – as you should about having children.

You should also discuss this option with your partner, if you have one, so that you’re on the same page about the consequences of permanent contraception. Your doctor will also have a thorough conversation with you before they’ll perform this procedure on you. Note that sterilization is illegal in some countries; check your national and local laws to know if this applies to your country.


Some doctors refuse to perform sterilization on young men and people who produce sperm, even if sterilization is permitted by law. They might think that you’re too young or that you’ll regret your decision (9). If this is the case, you can always try to find a different doctor, or you can contact your hospital’s or clinic’s patient support to discuss this matter. A medical professional has no reason to refuse treatment if you’ve made a well-considered decision, you’ve considered other options seriously, and there are no medical or legal reasons that you shouldn’t undergo this procedure. But they are allowed to refuse if they don’t think it’s in your best interest.


How does it work?

In a vasectomy, the structures that carries sperm cells from the testicles toward the penis (called the deferens ducts, one for each testicle) are interrupted. Sperm can no longer get out of the testicles, which means they can’t fertilize an egg. This is a 15-minute surgical procedure and is typically done by cutting the duct or tying it off, both of which can be done through the skin of the scrotum (the ball sack). Often, the skin itself doesn’t need to be cut for this, so you won’t bleed in this case. You’ll usually only need local anesthetic to numb the area.


How effective is it?

A vasectomy is very effective. With perfect use (that is, if you respect the time period in which it isn’t effective yet, see below), it’s about 99.9% effective, meaning only about 1 pregnancy per 1000 people* per year occurs. With typical use, this increases to about 2 pregnancies per 1000 people* per year (99.8% effective).

What are possible side-effects?

After the procedure, you may experience pain, bleeding, and sometimes infection. To allow healing, it’s advised not to ejaculate for about a week after the procedure.


Note that only a portion of people experience (some of) these side-effects, and some people will experience side-effects not listed here. Whether you will, depends on many different factors.


It’s good to know that a vasectomy is safer than tubal ligation (female sterilization) – this might be a factor you want to consider if you’re in a committed relationship and you’re discussing which birth control method you want to use.

When can't I use it?

There are few situations in which you can’t undergo sterilization. These situations are typically those in which it’s dangerous to undergo any surgery, or if you’re allergic to materials used in the procedure. Your doctor will indicate if your current situation is not a good fit for sterilization.


Does it work immediately?

No. Sperm cells can still be present in your semen for a couple of months. Usually, two to three months after you got your vasectomy, you’re asked to return to the hospital or clinic where you got the procedure done, so your semen can be analyzed. Only when this analysis shows that there are no sperm cells in your semen, can you rely on your vasectomy for contraception. Until then, you should use other forms of contraception, for example a condom or hormonal method.

What happens to my fertility if I stop using it?

A vasectomy is intended to be irreversible, meaning you’ll be permanently infertile. While your doctor can try to reverse it, there’s no guarantee that it’ll be successful. Generally, the chance of a successful reversal is higher if less time has passed since you got your vasectomy. Evidence suggests that up to 95% of reversals are successful (10), though your chance of success depends on your personal circumstances. If reversal isn’t successful, you can try assisted reproductive technologies like IVF – but these are often expensive and also aren’t guaranteed to work.

Does it protect against sexually transmitted diseases (STDs)?

No. If you’re having sex with someone new or untested, use a condom as well.




*People, here, means anyone who is able to become pregnant, including girls, women, and non-binary people and transgender men who still have their uterus, vagina, and ovaries.



Are you curious about other methods to protect yourself from an unwanted pregnancy? Read about other birth control options here!



This article is pending medical review.

Contributors

Written by Juliëtte Gossens

Reviewed by Sophie Oppelt and Selina Voßen

Edited by Juliëtte Gossens

 

References


  1. McFarlane I (ed.). Seeing the unseen: The case for action in the neglected crisis of unintended pregnancy. United Nations Population Fund. 2022. Available from: https://www.unfpa.org/sites/default/files/pub-pdf/EN_SWP22%20report_0.pdf

  2. Hacker NF, Gambone JC, Hobel CJ (eds.). Hacker & Moore’s Essentials of Obstetrics & Gynecology. 6th ed. Philadelphia: Elsevier; 2016.

  3. Hoffman BL, Schorge JO, Halvorson LM, Hamid CA, Corton MM, Schaffer JI (eds.). William’s Gynecology. 4th ed. New York: McGraw-Hill Education; 2020.

  4. Centers for Disease Control and Prevention. The United States Medical Eligibility Criteria for Contraceptive Use, 2016 (US MEC). Available from: https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/summary.html

  5. Centers for Disease Control and Prevention. 2016 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR). Available from: https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.html

  6. Siemons SE, Vleugels MPH, Balken van MR, Braat DDM, Nieboer TE. Male or female sterilization - the decision making process: Counselling and regret. Sexual & Reproductive Healthcare. 2022;33:10767. DOI: 10.1016/j.srhc.2022.100767

  7. Bryk DJ, Murthy PB, DeWitt-Foy M, Sun AY, Parekh NV, Sabenegh E et al. Childless Men at the Time of Vasectomy are Unlikely to Seek Fertility Restoration. Urology. 2020;136:142-145. DOI: 10.1016/j.urology.2019.12.003

  8. Charles D, Anderson D, Dietrich P, Sandlow J. MP34-03 Vasectomy in childless men: is regret more likely? The Journal of Urology. 2022;207(5S [Supplement]):e579. DOI: 10.1097/JU.0000000000002588.03

  9. Usborne S. ‘More people is the last thing this planet needs’: the men getting vasectomies to save the world. The Guardian. January 12th, 2022. https://www.theguardian.com/lifeandstyle/2022/jan/12/more-people-is-the-last-thing-this-planet-needs-the-men-getting-vasectomies-to-save-the-world [Accessed September 16th, 2022]

  10. Patel AP, Smith RP. Vasectomy reversal: a clinical update. Asian Journal of Andrology. 2016;18(3):365-371. DOI: 10.4103/1008-682X.175091


Please note: the information we provide to you here is for educational purposes only. If you’re experiencing any discomfort or have any complaints or questions about your health, please contact your doctor or other relevant health professional. We don’t provide medical advice.