A vasectomy is a surgical procedure for male sterilization or permanent contraception. During the procedure, the tubes that carry sperm, known as the vas deferens, are cut or sealed off. This prevents sperm from mixing with semen during ejaculation.
Effectiveness and Failure Rates
A vasectomy is a highly effective form of contraception, with a success rate of over 99%. The failure rate is approximately 1 in 2,000 cases, or about 0.05%, after a man has been confirmed to be sterile.
Achieving sterility is not immediate, as sperm can remain in the vas deferens for weeks or months. Other forms of birth control must be used until a semen analysis, performed two to three months after the vasectomy, confirms the absence of sperm. Some guidelines recommend two tests to confirm a zero sperm count, or a count of less than 100,000 non-motile sperm, for the procedure to be a success.
Early failures occur in about 0.3% to 9% of cases within the first six months, due to technical issues or early recanalization, where the vas deferens reconnects. The absence of a post-vasectomy semen analysis is associated with an increased likelihood of failure leading to pregnancy. Late recanalization, happening years later, is much less common but remains a possibility.
Prevalence of Vasectomy
Vasectomy is a common choice for contraception in the United States, though it is used less frequently than female sterilization. Data from the National Survey of Family Growth shows about 9.2% of women using contraception rely on their partner’s vasectomy, compared to 27% who rely on tubal ligation. Annually, it is estimated that between 175,000 and 354,000 vasectomies are performed in the U.S.
Among married or cohabiting couples, the disparity continues, with 22.1% relying on tubal ligation and 10.6% using a partner’s vasectomy. The average age for men undergoing the procedure is around 38. The decision to opt for sterilization is often linked to having reached the desired family size, as usage rates increase among couples with children.
Reversal Success Rates
Although a vasectomy is intended to be permanent, it can be reversed through a microsurgical procedure called a vasovasostomy. The success of this reversal is highly dependent on the amount of time that has passed since the vasectomy, as the procedure is most successful when performed sooner.
Success is measured in two ways: the patency rate (the return of sperm to the ejaculate) and the pregnancy rate. For reversals performed within three years of a vasectomy, the patency rate is approximately 97%, with a corresponding pregnancy rate of 76%. If the interval is between 9 and 14 years, the patency rate drops to 79%, and the pregnancy rate falls to 44%. For reversals performed 15 or more years later, the patency rate is about 71%, with a pregnancy rate of 30%.
Complication and Recovery Statistics
Short-term complications following a vasectomy are mild and infrequent. Recent data from a large UK study found the rate of infection requiring antibiotics was about 1.3%, and the rate of hematoma (a collection of blood under the skin) was 1.4%. These figures are lower than older estimates, which often quoted rates between 2% and 10%.
A long-term risk is post-vasectomy pain syndrome (PVPS), a condition of chronic testicular pain. Estimates on the incidence of PVPS vary; a 2020 meta-analysis suggests it occurs in about 5% of men, while other studies report that severe pain affects approximately 1-2%. The majority of these cases can be managed with medical or surgical treatment.