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There are so many different ways to prevent pregnancy! There are barrier methods, injectables, pills, patches, rings, and implants, or even some combination of any of those. However, all of those are temporary. They can also be very labor and time intensive. You have to either remember to purchase items or remember to take a pill every day or have doctors appointments for a shot or an implant. That can be quite the hassle. Additionally, some of them have pretty high pregnancy rates. For example, condoms have an 18-20% failure rate. The pill has around a 10% failure rate. 

A lot of people, once they decide they do not want any more children, are looking for a more singular, long-term option that is very effective! The more permanent forms of contraception are vasectomies for men and tubal ligations for women. The difference between those two is discussed in another article on our blog.

So, if you and your husband decide to go the vasectomy route, do you still need to use another one of those forms of contraception? Well… yes and no! Let’s talk about it. 

What is a Vasectomy?

Men have a structure called the vas deferens that carries the sperm from where they are stored to where they will be released at time of ejaculation. A vasectomy involves the removal of a piece of this tube. That way, when ejaculation happens, sperm can no longer reach the ejaculate, thus preventing pregnancy. This is considered a permanent form of sterilization. It does not affect sperm production and can be reversed, but this is not guaranteed to be successful and is very expensive!!

Why is this such a great option? Because it is a minimally invasive office-based procedure. It does not require the use of general anesthesia. The risks of any adverse complications are very low. Additionally, it is much more cost-effective compared to other forms of birth control in the long-run.

Post-Vasectomy Testing

The biggest thing to understand after a vasectomy is that it takes time before a man is actually sterile. 

Even though a piece of the vas deferens is removed, there is still sperm present in the part that stays, which means sperm can still make it into the ejaculate for a period of time. 

To know if the vasectomy was successful, we have to confirm with a test called a semen analysis. Most labs evaluate the semen just for the presence or absence of live sperm, rather than provide a sperm count. The sample is collected at home and taken or sent to a lab, who will send you the results. Based on several studies, we can gather that most men will be free of sperm by 50 ejaculations after the vasectomy, so the testing is done after this time-frame. 

Most men are sperm free by this point, but some men may take longer. If the first test shows the presence of sperm, try not to worry right away. The test can be repeated 1-2 months later. 

Need for Birth Control after Vasectomies

Birth control should definitely be used to prevent pregnancy in the immediate time frame after the vasectomy. As mentioned above, it takes time for all of the sperm to clear out of the tubes and for the ejaculate to be sperm-free. So, if the goal is to 100% prevent pregnancy, other forms of birth control should be used until the lab gives you the all clear. 

Risk of Pregnancy after Vasectomies

It is still possible to have a pregnancy after a vasectomy, but the rates of that are very low. Multiple studies have cited post-vasectomy pregnancy rates of about anywhere from 1/1000 to 11.4/1000 which would make a vasectomy 98-99.9% effective. 

There are a number of reasons pregnancy can occur after a vasectomy. The most common reason for an early failure of a vasectomy is the couple choosing not to use another form of contraception during the “waiting period”. 

Later on, failure of a vasectomy is typically related to “recanalization” or reconnection of the two separate vas deferens tubes. The risk of this is greatly reduced with using multiple techniques to separate the vas. Most surgeons remove a piece and use other methods to seal the tubes like cauterization and even putting the two tubes in different layers of the scrotum. 

At Purely Vasectomies, we have highly trained and specialized Urologic Surgeons who do their best job to ensure the vasectomy will be successful!

Other Benefits of Birth Control

Despite vasectomies being a highly effective form of birth control, there are a variety of reasons couples may choose to use other forms of contraception in addition to a vasectomy! 

Hormonal forms of birth control can be helpful for women who may have health conditions such as PCOS or dysmenorrhea (painful, heavy periods). The hormonal birth control forms that prevent ovulation can be protective and reduce the risk of ovarian cancer in women in the future. A salpingectomy, which is a permanent form of sterilization for women, is also protective and reduces the risk of ovarian cancer in women in the future. 

Barrier forms of contraception, like condoms, are the only forms that protect against sexually transmitted infections. 

Additionally, some people just have a “belt and suspenders” type of personality. Knowing that there are multiple fail-safes in place to prevent pregnancy can boost confidence and make sex less stressful/more fun!

While a vasectomy is a permanent form of sterilization, it is not an immediate form of sterilization. Birth control should be used to prevent pregnancy in the time frame between the vasectomy and the confirmation from the lab that there is no sperm in the ejaculate. Once you have confirmation, you can stop using other forms of birth control with confidence that the vasectomy was successful!! There may be other reasons for couples to use other forms of birth control even after a vasectomy, and that is fine, too!