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Health and Wellbeing

The Fellow Guide to Vasectomies

By The Fellow Team July 18, 2020

Here’s some fun trivia: what do Dr. Phil, Ozzy Osbourne, and Slim Thug all have in common? If you know the answer then you’ve definitely been paying attention to the Fellow Blog. For everyone else: all three of these celebrities have had a vasectomy – along with 500,000 other men in the United States every year!1 Welcome to Getting a Vasectomy 101. Maybe you’ve been curious about getting a vasectomy for a while, but want to understand the details a bit more. Maybe you haven’t thought about a vasectomy at all but are curious about exploring a permanent form of birth control. Maybe you’re someone who wants your partner to get a vasectomy. And maybe you’re a male reproductive health junkie (like we are), in which case, welcome, and we salute you. Let’s dive in.

First things first: the vas deferens.

Before we talk about what happens during a vasectomy we’re going to back up and chat anatomy. More specifically: we’re going to talk about the vas deferens. Sperm is produced in your testicles, which live in your scrotum. Once the sperm are mature and ready for action they hang out in the epididymis, a coiled tube located behind the testicles. The vas deferens is the tube that connects the epididymis to the prostate, and then on to the urethra, where sperm mix with seminal fluid and become the ejaculate that travels out of the penis upon climax. Think of the vas deferens as the super highway that allows sperm to move from your testicles into your ejaculate.2

What happens to a man when he gets a vasectomy?

TLDR: the vas deferens is cut and the super highway is blocked, no longer allowing sperm to meet up with the seminal fluid, rendering your ejaculate sperm-free. But because we know you’re not just here for the TLDR version, let’s dive into the details.

Getting a vasectomy is a common, quick (10-30 minutes), and typically painless surgery. During a vasectomy, a doctor will cut and cauterize the vas deferens. There are two types of vasectomies your doctor might consider. An incision vasectomy involves your doctor (typically a urologist) making 1-2 small incisions in your scrotum through which they expose the vas deferens. You may be under general anesthesia or local anesthesia, depending on your specific case.3 Your doctor will then cut and cauterize the vas deferens, or block it off with ties or surgical clips. You’ll get some stitches in your scrotum and then you’ll be done – often in and out of surgery within 20 minutes.4

The other type of vasectomy your doctor may consider is a no-scalpel vasectomy. Like the name implies, this type of vasectomy involves just a tiny hole punctured through the skin of the scrotum, through which the vas deferens is ligated (tied off). You won’t get stitches for the no-scalpel vasectomy method.

The type of vasectomy that you decide on depends on your personal preferences, your doctor’s experience, and what your doctor thinks is right for you. You’ll discuss all of this in the appointments you have with your doctor before the actual procedure.

#Spermstat: Did you know that March is a particularly popular month for vasectomies? Reportedly this is because many men choose to time their procedure with March Madness so that they can chill on the couch and recover post-vas. Some physicians have even reported reaching “max capacity” in the weeks leading up to the tournament.5

How painful is a vasectomy?

Generally you should experience very little pain! Vasectomies are typically done at a urologist’s office or clinic, meaning you won’t have to go to a hospital (this is called an outpatient procedure). While some bruising, swelling, and minor pain may be expected post-surgery, most men need just a few days of rest before feeling back to 100%.6

What happens during a vasectomy recovery?

After a vasectomy you’ll still ejaculate, but your semen won’t contain any sperm. Needless to say, vasectomies are a highly effective form of birth control!Important caveat:it can take up to 3 months for your semen to be completely sperm-free. If you’re getting a vasectomy for birth-control related reasons, be sure to use an alternate form of birth control until your doctor confirms that your semen is free and clear of sperm.7

Because sperm make up only approximately 5% of the volume of your semen, you typically will not notice any difference in the amount of ejaculate pre and post vasectomy. Your sexual sensation, from arousal to orgasm, should be unaffected, but if you experience any pain make sure to talk with your doctor.

Another thing that won’t be impacted? Your testosterone levels.8

Can I reverse a vasectomy?

You can generally reverse a vasectomy, and approximately 5% of men who’ve gotten a vasectomy do so.9 During a vasectomy reversal, a doctor will cut into the scrotum to reattach the severed ends of the vas deferens back together. If sperm become present in your semen, the process will end there. If sperm is not present, your doctor may connect your vas deferens directly to the epididymis, the tube behind your testicles where sperm hang out. This is called avasoepididymostomyand is a more complicated procedure than a vasectomy reversal (called avasovasostomy).

A successful vasectomy reversal (when sperm reappear in ejaculate and a successful pregnancy may be possible) happens with approximately 30-90% of surgeries.10 The biggest indicator of whether a vasectomy reversal will be successful is the amount of time between vasectomy and vasectomy reversal. The longer the time, the more likely the vas deferens will have become more blocked.11 As an extra precaution, some men choose to bank their sperm prior to their vasectomy, just in case they later change their mind about wanting (more) children and are unable to reverse the vasectomy.

How much does a vasectomy cost?

Most health insurance plans (including Medicaid) cover vasectomies. The cost of the procedure will depend on whether you have insurance, your specific plan, and your doctor. As for vasectomy reversals, many plans do not cover this cost. The price of the procedure can range, generally speaking, from $7,000 to $9,000 – so be sure to consider this cost when evaluating your options.12

If you’re sure you don’t want (more) biological children, a vasectomy can be a great option to consider. If you’re not positive? Maybe hold off – reversals can be costly and may not guarantee a successful pregnancy.

And that’s that! Now that you’re up to speed on vasectomies, check out our article on other forms of male birth control.

This article is for informational purposes only and is not medical advice. Do not rely on this for medical advice. As always, consult your doctor with any questions.

The Fellow Team

It would be nigh impossible to find a bunch more passionate about fertility than the Fellow Team. We are a group of colleagues who loves to author articles in our free time (that is, when we aren't challenging each other to games of Code Names). You can reach us at blog@meetfellow.com.

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