5 Things Partners Should Discuss Before Getting a Vasectomy

To the outside observer, it might seem that when, say, a friend tells you they recently had a vasectomy, it was a pretty open-and-shut situation: They didn't want to have more kids—maybe no kids in the first place—so they went in for a snip.

But a lot goes into that decision, one that should be taken seriously and involve plenty of discussion between partners. About what, though, beyond the no kids aspect? Well, experts have some thoughts about what to consider, personally and with your partner, before deciding to get a vasectomy. Here are five thoughts to keep in mind.

1. Are we sure we're done having kids?

Deciding whether or not to have more children can be a laborious process, and couples should take it slowly as they figure it out.

"There's always a little bit of unknown in both directions, and there's a potential for regret," said Scott Lundy, M.D., a urologist at Cleveland Clinic's Glickman Urological & Kidney Institute.

There are a variety of internal and external factors to sift through as you try to answer this question, said Michael Mangino, Psy.D., a couples psychologist with Philadelphia Couples Therapy.

This calculus is always directly relevant to the number of children you may already have, including their specific needs.

"The internal factors really have to do with the relationship you would have to a child, the relationship you would have to your partner while parenting, the relationship you would have to your family and the way in which this would impact your family dynamic," Mangino said. "Versus the external factors which people talk about: finance and cost, childcare, how you navigate your job and how working would happen in relation to childcare, so on and so forth; the things that really impact the parents together."

Consider some specific questions with yourself and with your partner:

• If you have kids already, have you enjoyed being a parent so far? Can you handle the emotional stress of having another child?
• Do you have the financial resources to support another kid?
• Do you have the time to be physically and emotionally present to another child in the ways that you think you should and need to be as a parent? This can be both general, based on an individual child's emotional needs, or a whole other calculation if you have children with special needs.
• Do you and your partner work well together as parents? Are you managing the stress of being a parent well within the boundaries of your own relationship? And can you continue to do these things with another child?
• You have to think about the kind of parent you are capable of being and what you want to be to your kids at each phase of their lives, including as teens and into their adulthood. How would that be impacted by having another child?

At the end of each of these considerations, if the answer is no, add "might you in the future?" If you are considering undergoing voluntary sterilization, it's worth thinking about in case you aren't ready to have another child right now but might change your mind months or years down the road.

Ultimately, the question comes down to what you, as parents, want, what you can provide, and what is right and fair for the children you may already have and the child you might add to your family.

"When I come to this conversation, I'm really thinking about just considering children's needs above fantasy, because that's really a loving decision," Mangino said.

If you decide you're done having kids and want to make sure pregnancy doesn't occur by accident, the next step is to decide which partner is going to be sterilized.

2. Why get a vasectomy instead of tubal ligation?

The choices boil down to the male partner getting a vasectomy or the female partner getting a tubal ligation. Vasectomies are a great choice because they are safe and 99 percent effective, Lundy said.

"It is a safe option, it is reliable, it is less risky than a [tubal ligation] because it doesn't require any surgery inside the abdomen, and it is a short procedure that takes 10 to 20 minutes, and then you can go home and rest and you're back to yourself in a few days," he explained.

Mangino said a vasectomy is the more equitable decision, especially for couples with children. The female partner has already put her body through a lot to bear children, not to mention the hormonal effects of years of birth control for women who have used it. This is a time for the male partner to step up and bear the physical load of family planning.

3. A vasectomy is not an instant solution

This point is critical to understand: It takes eight to 12 weeks before ejaculate is free of sperm. Sometimes it takes longer, and you really won't know unless you have follow-up testing done, which is something Lundy estimates half of vasectomy patients don't do.

"I think the partner plays a significant role in encouraging the men in their lives to have this testing done, because it's critical," Lundy said. "The ones who come back with a pregnancy are pretty bummed they didn't get checked."

4. There is a healing process, and both partners have to respect it

The doctor who performs the surgery usually tells the patient to apply ice to the incision and stay off their feet for about 24 hours. After that, they need to avoid heavy lifting (10 pounds or more), strenuous exercise and sexual activity for seven days.

That might be easier said than done, particularly for parents of small children, but it's crucial that both partners respect the parameters of the healing process, Lundy said. If you don't follow the healing process, you increase the risk of complications or delay the healing process.

So while it might seem easier for dad to carry the toddler upstairs to bed, both partners should understand that—for at least a week—that's not one of his duties.

5. Vasectomies are reversible

Say you go through all of your decision-making about whether or not to have kids and you come to the conclusion you're done. Then you get the vasectomy, recover and move into post-fertility freedom.

Except that one day, you and your partner realize you actually weren't done: You want to expand your family.

There are two ways you can do this. One is by extracting sperm from the testes to then be used for in vitro fertilization (IVF). The other is to have a vasectomy reversal, a procedure that takes one to two hours, requires a general anesthetic and during which the vas deferens are surgically reconnected.

"That operation is highly successful," Lundy explained, adding that there is a success rate of more than 90 percent in returning sperm to ejaculate through vasectomy reversals.

Both of these options require a not-insignificant amount of money, and you should do your homework. There are a lot of people out there who aren't urologists—some who aren't even surgeons—who claim 100 percent success and would be more than happy to do a vasectomy reversal for you, Lundy said.

So while you should consider a vasectomy a permanent solution, it doesn't necessarily have to be one.

If you want to have kids and neither a sperm extraction nor a vasectomy reversal is a good option for you, there's still another option, Lundy said: adoption.