Family planning is complete, partners are looking for a reliable method of contraception. Preferably one that you don’t have to think about while you devote yourself to the most beautiful thing in the world. Time for sterilization? The perfect contraceptive method does not yet exist, so individual needs and life circumstances must be taken into account. We provide information about vasectomy, male sterilization.
Sterilization: usually irreversible
For couples older than 30, who already have children or are sure they do not want any more, surgical intervention for sterilization is an effective and very safe alternative to all other methods. However, this step towards permanent infertility is almost always irreversible – in order not to regret it later, partners should be sure that their attitude towards having children will not change again. In Germany, about 1.45 million women have currently undergone sterilization, which corresponds to about 8% of all women of reproductive age. For men, it is about 2% of men of reproductive age – with an upward trend.
Sterilization in men and women
With sterilization, the natural path of the sperm is blocked, preventing the egg from being fertilized. If sterilization is an option for the couple, it is necessary to consider who will undergo the operation. Factors to consider are:
- Age
- Existing diseases
- The mental resilience
Before making a final decision, the partners should in any case be informed by a doctor about the exact procedure, risks and consequences. Also counseling centers such as Pro Familia can provide assistance. In principle, the procedure is smaller, faster and has fewer complications in men. It can be performed on an outpatient basis under local anesthesia, whereas the woman must be sterilized under general anesthesia.
Vasectomy: no side effects
Most men find the decision to undergo sterilization easier if they know that afterwards the desire for sex is as little affected as erection and ejaculation. Because only a small portion of the seminal fluid is sperm, its consistency, quantity and color remain unchanged. Hormone production is also unaffected, as hormones are transported through the bloodstream. Many men even report a positive impact on their sex life, presumably because it can develop more freely without the fear of unwanted pregnancy.
Sterilization procedure
Male sterilization is almost always performed under local anesthesia on an outpatient basis in a doctor’s office or clinic. The patient must carefully shave his abdomen beforehand for this. The doctor disinfects large areas and places several anesthetic injections in the groin and scrotum. He waits a few minutes for the anesthesia to take effect. The vas deferens in the two scrotums are operated on one after the other. To do this, a small incision is made in the scrotum, the vas deferens is dissected free, pulled out and cut. A piece about 3 to 5 cm in size is removed from the vas deferens, the two ends are welded and sutured with an absorbable thread or closed with clips. After that, the skin of the scrotum is sutured again. The procedure itself is painless, the first few days afterwards there may be slight pain and swelling.
Complications and consequences of vasectomy
Possible but rare complications are mainly bleeding, infection and adhesions. In rare cases, spontaneous reunion of the severed vas deferens may occur. Sperm may still be present in the seminal vesicles and thus in the seminal fluid for up to 12 weeks after the procedure, leading to fertilization. So during this time it is theoretically possible to get pregnant despite sterilization. Therefore, the couple must use contraception during this time and several samples of the ejaculate are checked in a spermiogram – usually after 6, 12 and 18 weeks. Only when two of these samples are sterile, the operation is declared successful. Incidentally, the testicle continues to produce sperm, but the body breaks them down again and their number decreases sharply over time.
Cost absorption: health insurance vs. paying yourself
In contrast to the past, the cost of male sterilization is now usually no longer covered by health insurance. This is especially true if the procedure is performed only because of personal life planning. Exceptions are vasectomies, which are medically necessary. Private health insurance companies also usually only cover the costs if the procedure is performed for health reasons. The cost of a vasectomy is about 400 to 600 euros.
