An­drea Helten

Be­co­ming a fa­ther after a vasec­tomy 

What is a vasec­tomy?

Vasec­tomy re­fers to the cut­ting of the vas de­fe­rens in men. It is con­si­dered a re­li­able me­thod of con­tracep­tion, has re­la­tively few com­pli­ca­tions and in­volves a much lower sur­gical risk com­pared to the ste­ri­liz­a­tion in women. Vasec­tomy should not be con­fused with cas­tra­tion, in which the testi­cles are re­moved, drasti­cally al­te­ring the hor­monal ba­lance.

Ste­ri­liz­a­tion or vasec­tomy does not in­ter­fere with hor­monal ba­lance: sperm pro­duc­tion con­ti­nues. By cut­ting the vas de­fe­rens, there are me­rely no more sperm in the eja­cu­late — sperm trans­port is per­ma­nently in­ter­rupted. After a vasec­tomy, the partner feels just as much plea­sure du­ring sex as be­fore and the pro­ce­dure also has no di­rect in­flu­ence on erec­tion and or­gasm.

Becoming a father after a vasectomy

How does a vasec­tomy work?

In a classic vasec­tomy, a small in­cision is made in the skin of the scrotum after local an­esthesia, through which the vas de­fe­rens of both testi­cles are ex­posed. Then, ap­pro­xi­mately 2 cm long pieces are taken from the left and right vas de­fe­rens. The se­vered and thus shor­tened vas de­fe­rens are scle­rosed at their open ends, sutured and re­po­si­tioned. The testi­cles are sutured in the next step. The classic me­thod takes about 15 mi­nutes per testicle.

Mo­dern pro­ce­dures such as the so-called non-scalpel vasec­tomy offer an even gentler form of male ste­ri­liz­a­tion: here, the skin on the scrotum is no longer cut with a scalpel, but punc­tured in one or two places. Vasec­tomy wi­thout a scalpel takes only about 15 to 20 mi­nutes.
The small ope­ning is simply co­vered with a ste­rile dres­sing and heals on its own.

How safe is a vasec­tomy?

Whe­ther a con­tracep­tive me­thod is safe or less safe can be mea­sured by the “Pearl Index.” The lower the “Pearl Index,” the safer the me­thod. Vasec­tomy is one of the safest me­thods of pre­ven­ting un­wanted pregnancy; ac­cording to Pro­Fa­milia, its Pearl Index is 0.1. By com­pa­rison, the Pearl Index of the birth con­trol pill ranges from 0.1 to 0.9.

From now on, one thing should be clear to you: a vasec­tomy is only a small cut, but it has far-reaching con­se­quences. The de­cision for or against male ste­ri­liz­a­tion should the­re­fore not be taken lightly. There are ways to re­verse a vasec­tomy (see below to find out how), but there is no gua­rantee that you will be able to con­ceive again.

The­re­fore, the German So­ciety of Uro­logy also ad­vises against a vasec­tomy if no children have been con­ceived so far, the man is younger than 30 years old, suf­fers from chronic testi­cular pain or is cur­r­ently not in a part­nership. Also, an emo­tional crisis should not serve as a re­ason for this pro­ce­dure.

What are the costs for a vasec­tomy?

De­pen­ding on the prac­tice, you should ex­pect to pay around 500 euros (in­clu­ding follow-up ex­ami­na­tions). The he­alth insurance com­pa­nies do not cover the costs.

Vasec­tomy and the de­sire to have children

Vasec­tomy is re­com­mended for men who do not wish to have children or who have com­pleted their fa­mily plan­ning. But what if after a vasec­tomy there is still a de­sire to have children? This is the case for about 30% of ste­ri­lized men. And still about 6–10% of men who have had a vasec­tomy de­cide to have it re­versed.

Is it pos­sible to re­verse a vasec­tomy?

Yes, it is pos­sible. A re­peat sur­gery, called a va­so­vaso­s­tomy, re­con­nects the se­vered vas de­fe­rens. Here, a spe­cial sur­gical mi­cro­scope al­lows the sur­geon to en­large the tiny vas de­fe­rens up to 20 times in order to re­con­nect their ends. After all, 90% of the ope­ra­tions are crowned with suc­cess and the abi­lity to pro­create is res­tored.

There is dis­agree­ment as to whe­ther the time factor plays a major role or not. Many sources in the In­ternet re­port that the longer the pe­riod bet­ween vasec­tomy and re­fer­ti­liz­a­tion, the lower the pro­ba­bi­lity of pregnancy. For ex­ample, the German Fe­deral Center for He­alth Edu­ca­tion (BZgA) states on its web­site that only half of ste­ri­lized men will fa­ther a child again if the re­fer­ti­liz­a­tion took place wi­thin three years of the vasec­tomy. If the pro­ce­dure took place even longer ago, the chances de­te­rio­rate fur­ther. However, there are also other, more hopeful pro­gnoses, which state that the con­nec­tion bet­ween time and chances of suc­cess simply does not exist. Ra­ther, they say, it’s cru­cial that “the dia­gnostic and part­nership pa­ra­me­ters are right.”

What are the costs for a re­fer­ti­liz­a­tion / va­so­vaso­s­tomy?

At least 2000 euros must be ex­pected and thei are not co­vered by the he­alth insurance.

Be­co­ming a fa­ther through as­sisted re­pro­duc­tion

If a re­fer­ti­liz­a­tion is not pos­sible or if it is not to be re­versed de­s­pite the de­sire to have children, cou­ples can con­sider ano­ther op­tion after vasec­tomy: Testi­cular sperm ex­trac­tion (TESE). Here, tissue sam­ples are taken from the testi­cles via a small pro­ce­dure and ex­amined for sperm that are ca­pable of fer­ti­liz­a­tion. If these are found, the sam­ples can be frozen and used for fer­ti­lity tre­at­ment (ICSI). TESE re­quires a tho­rough preli­mi­nary ex­ami­na­tion in­clu­ding a sper­mio­gram. It costs around 2500 to 3000 euros, which is also due pro­por­tio­na­tely if no fer­ti­liz­able sperm are found. However, he­alth insurance com­pa­nies usually con­tri­bute to the costs of sur­gical pro­ce­dures to ob­tain sperm if cer­tain con­di­tions are met.

About Fer­tilly

At Fer­tilly, we have made it our mis­sion to ac­com­pany cou­ples (ho­mo­se­xual and he­te­ro­se­xual) and sin­gles on the way to ful­fil­ling their child wish. In doing so, it is im­portant to us to create trans­pa­rency in the area of fer­ti­lity ser­vices, to pro­vide in­for­ma­tion and know­ledge on the to­pics of pregnancy and fer­ti­lity and to help you to find the most sui­table Fer­ti­lity Center. Through coope­ra­tion with first-class Fer­ti­lity Cen­tres and cli­nics in Eu­rope, en­qui­ries about Fer­tilly are given pre­fe­ren­tial tre­at­ment. This means that our pa­ti­ents avoid the usually long wai­ting times and get ap­point­ments more quickly.

If you would like more in­for­ma­tion about Fer­ti­lity Cen­ters, suc­cess rates and prices, please con­tact us using this ques­ti­onn­aire. We will ad­vise you free of charge and wi­thout any ob­li­ga­tion.

  • An­swer the first ques­tions in the on­line form in order to book an ap­point­ment. This way we can better ad­dress your needs du­ring the con­ver­sa­tion.

  • We will find the best con­tact person for your in­di­vi­dual needs. Sche­dule 20 mi­nutes for the con­sul­ta­tion.

  • We will in­tro­duce you to the right fer­ti­lity clinic from our net­work, make an ap­point­ment and ac­com­pany you until your wish for a child is ful­filled.

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