Fertility

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The ins and outs of a vasectomy

While remembering to take the pill every day is difficult at the best of times, when dealing with kids and other responsibilities and the risk of an unplanned pregnancy takes any spontaneity of being intimate out of the equation.

Vasectomy - a procedure where the Vas Deferens is cut - is a popular and fairly painless option for couples who don't want to get pregnant again.

Auckland-based Dr Jonathan Masters has carried out over 6000 vasectomies.

"Plenty of people know about vasectomies and they are 10 times more successful than the next best form of contraception," he told Essential Mums.

Dr Masters says the failure rate of a woman having her tubes tied is one in 600, on the pill, one in 90 and with vasectomies one in 2000.

"It's the best form of contraception by a country mile and fairly common once a couple have had their family," he says.

How does it work?

Sperm is made in the male testicles and travels along the Vas Deferens (a tube which passes from the testicles to the urethra, which then goes to the end of the penis) to mix with a fluid called semen during ejaculation.

The Vas Deferens is cut in a vasectomy, therefore the sperm do not mix with the semen - ejaculation still takes place but there are no sperm in the semen. The sperm will still be produced in the testicles, but is absorbed by the body.

"It is not considered major surgery and is done in nine minutes," says Dr Masters.

"Patients can drive themselves to the clinic and back and it is all over in 30 minutes."

It is advisable not to do any heavy lifting for three to four days afterwards, but the procedure itself doesn't impede on work.

"Everything works the same afterwards, the ejaculate is still the same, the colour, texture and volume is still the same. That is something many patients ask me about and it seems that it is a worry, but everything happens as it did before the operation."

Vasectomies are also more effective than women having their tubes tied, the latter being a far more complicated and painful procedure.

The vasectomy procedure uses local anaesthetic - approximately 5ml - about the same amount used when getting a filling at the dentist - and the sting of the anaesthetic going into the skin lasts about two seconds.

The incision is so small that it does not even require stitches.

"The failure rate for having the tubes tied is one in 200. It is a bigger operation and it is about five times more expensive than vasectomies."

The cost of vasectomies ranges between $300 and $500.

Can it be undone?

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It is possible to reverse a vasectomy, but it is an intricate and time consuming process.

"It is a fine procedure and takes a bit of effort to reverse and would cost about $6000. The time from the initial vasectomy to the reversal also influences the outcome," Dr Masters explains.

"Men can bank sperm if they would like to. I have had a lot of patients ask about sperm banking, but for every 100 that ask about it, maybe one will actually do it. I have noticed over the years that reversals are more common than sperm banking."

Dr Masters believes that the higher divorce rate may have something to do with the number of reversal requests.

"Men might meet a new partner who wants to have a baby and that is why they might want a reversal," he says.

"I would very rarely take anyone below the age of 30 who hasn't had children, but if someone is in their thirties, has had their family and don't want to have anymore, that's fine."

Important to remember

It is important to continue to use another method of contraception after the operation to make sure it was successful.

This means the man would need to ejaculate at least 24 times to make sure the procedure was successful; this is because fertility exists for at least 12 to 14 weeks after the vasectomy.

For this reason, sperm samples would need to be collected and analysed and once there are two clear samples in a row, you can have unprotected sex.

The operation does not impact on male hormones, so it would not affect masculinity, erection or ejaculation at all.

If you had the procedure on a Friday, you would be able to be back at work on Monday, but it is important to rest over the weekend.

Sports, strenuous exercise and heavy lifting should be avoided, there may be a small amount of bruising or swelling of the scrotum after the procedure but will disappear.

- Essential Mums

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