Reversible vasectomy?
Dear Alice,
What other methods are available for male birth control without sterilization, condoms, or foams. I've heard there is a procedure for a reversible vasectomy where the tubes are clamped rather than cut, allowing for a future reversal. What do you know about this?
— May want kids in the future
Dear May want kids in the future,
Contraceptive options for men are still generally lagging behind women's options in terms of variety. Essentially, men who wish to avoid pregnancy have three options right now, using condoms, using the withdrawal method (“pulling out”) or having a vasectomy. You are correct that some vasectomies do not actually sever the vas deferens (the tube that sperm travel through from the testes) — a 'no cut' procedure instead uses clips to block the vas deferens. It's possible the clip method reduces pain and side-effects associated with traditional vasectomies; however they provide no guarantee of reversibility and may be somewhat less effective in preventing pregnancy than the old "snip snip."
You may also have heard about a procedure called the "no scalpel vasectomy," where a clamp is used as a surgical instrument; however, the vas is still cut and reversal is difficult. A doctor invented this technique in China, where it has been widely used for some time now. More and more doctors have been performing "no scalpel" vasectomies. This particular procedure has gained popularity because it does not require stitches, and there is much less post-surgical pain associated with the operation.
Regardless of how the vas is severed or clamped, vasectomies are generally considered permanent... Reversal procedure success rates, in terms of pregnancy rates, tend to be very low. The primary factors that influence the success of a reversal are: length of time between vasectomy and reversal, partner's fertility, patient's general health and age, technique used for reversal, and the presence of sperm antibodies.
Interesting though this may be, you wrote for more practical information, right?
If you are in a relationship (and plan to stay that way), you and your partner might want to discuss male and female birth control options and decide upon those you both can live with until you decide to have children (assuming you agree that you both want kids!). Most health care providers would recommend waiting until after having children to have a vasectomy, mainly because the chances of being able to impregnate a woman would be pretty slim after a reversal surgery.
If you are single, an additional consideration is safer sex. A vasectomy will only prevent the release of sperm (but not semen) and would not provide protection against sexually transmitted infections (STIs). In this light, a vasectomy is not a safer sex method. In fact, having a vasectomy could even tempt you to forgo condoms since you would not be worried about pregnancy.
If you would like more information on vasectomies and other birth control options, you might consider speaking with a health care provider or visiting your local Planned Parenthood. You can also read about other available methods of male and female contraception in the Go Ask Alice! Contraception category. Though not approved just yet, there are newer methods of male contraceptives in development and in clinical trials; you may even be able to take advantage of some of them before you're ready to have kids.
Originally published Apr 19, 1996
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