Vasectomy vs. tubal ligation - Comparing pros and cons

Vasectomy vs. tubal ligation - Comparing pros and cons

The decision to seek permanent sterilization should be well-thought out and researched by both men and women.  It is not a decision to make on the spur of the moment and you want to be completely positive that you are done making babies or do not have the desire to become a parent.

In the United States, about 500,000 men undergo a vasectomy whereas between 550,000 to 789,000 tubal ligations are performed yearly.  Vasectomies are cheaper, faster, and safer than female sterilization yet only 9% of men in the U.S. get them while 27% of women get tubal ligations.

Comparing the risks and benefits of vasectomy versus tubal ligation needs to be considered and discussed with your healthcare provider.  Whichever form of permanent birth control a couple chooses, make sure you both agree on it and have weighed the pros and cons of each procedure.

Tubal ligation

Also known as “getting your tubes tied,” tubal ligation is a permanent solution to birth control for women and is usually done laparoscopic.  The procedure involves cutting and tying the fallopian tubes to prevent eggs from being able to move from the ovaries to the uterus and to block sperm from reaching the egg.  Women should realize this form of birth control is permanent sterility and is not reversible.  Many women choose to have a tubal ligation within a day or so after giving birth, in conjunction with a cesarean procedure, or any time that does not conflict with her menstrual cycle.

Pros of tubal ligation

·      It’s considered a very safe and well-tolerated procedure for most women.

·      A woman will no longer have to worry about birth control options or remembering to take birth control pills.

·      Without having to worry about pregnancy, interest in sex can increase.

Cons of tubal ligation

·      Side effects are very rare however potential risks include perforation of the intestine, infection, complications from anesthesia, and pulmonary embolism.

·      It can have a failure rate of up to approximately 0.25 to 0.5 percent depending on how it was performed and age of the patient.

·      If a woman was not completely sure of her decision, there can be a high rate of regret of no longer being able to become pregnant.

·      It does not protect a woman from sexually transmitted diseases.

·      The procedure does require hospitalization, general anesthesia and it’s a lengthier, more complicated surgery than a vasectomy.

·      There can be considerable amount of pain in the area where the surgery is performed but generally recovery is within a week.

·      Tubal ligations are more costly running between $5,000 to 8,000.

Vasectomy

Vasectomies are considered a permanent method of birth control for men preventing the release of sperm when a man ejaculates.  When a man reaches orgasm, sperm from the testes enter through two narrow tubes called the vas deferens and mix with semen to form ejaculate.  The procedure involves severing the male vas deferens, then tying or sealing them in a manner to prevent sperm from entering into the seminal stream therefore preventing pregnancy. A man will still ejaculate and it will still feel the same but there won’t be any sperm in the seminal fluid.

Pros

·      Usually this is an outpatient procedure performed in the doctor’s office with a local anesthetic in less than 30 minutes.  The procedure involves making a small cut or puncture into the scrotum, pulling out the vas deferens, cutting it off and sealing it shut before closing the incision.

·      A man can be back to work with 24 hours and can resume regular physical activities with a week.

·      The procedure does not affect testosterone levels so a man does not have to worry about being less of a man.

·      Vasectomies have a very high success rate of 99%.  But a backup method of birth control needs to be used for the next 3 months.  A man needs to ejaculate at least 20 times after a vasectomy to make sure no sperm are left in the duct.  Generally a man follows up with his doctor within 8 to 12 weeks to check the sperm count.

·      Vasectomies can be reversed with about a 70 to 90% success rate.

·      There is no change in sexual desire or the amount of semen output when he ejaculates.

·      Having had a vasectomy does not put a man at higher risk of prostate cancer.

·      The cost of a vasectomy is usually under $2,000 and generally covered by insurance. 

Cons

·      If a man decides he wants to reverse his vasectomy, it can cost up to $10,000 and is not covered by insurance.  The reversal is also not guaranteed.

·      Vasectomy reversal is risky and is more complicated than a vasectomy.

·      Common complaints after a vasectomy include swelling, bruising, and pain but these symptoms usually subside quickly and respond well to ice packs, mild pain relievers, and rest.