Our family is just the right size, what can I do so my wife doesn’t have to keep taking birth control?
When you and your spouse know you are done having children, you have many ways to prevent future pregnancies. There are different hormonal methods for women from daily combined hormonal contraceptive pills (the pill) or long acting reversible contraceptive methods which last several years.
These include intrauterine devices (IUDs) which last five years or the implantable Nexplanon rod which works for three years. The copper IUD, which prevents pregnancy for up to 10 years, is the only reversible nonhormonal option.
Permanent sterilization methods, which cannot be undone, block the movement of sperm or eggs to prevent pregnancy. When the sperm can’t connect with an egg, the egg isn’t fertilized so no pregnancy.
Options for women are to block the unfertilized egg from reaching the uterus and include tubal occlusion with Essure in the clinic or tubal removal in the operating room. For men, there is only vasectomy, the surgical blocking of the connection between the testicle and the penis. This works by blocking the sperm from exiting the testicle by severing and removing a section of the vas deferens from each testicle.
The good news is that vasectomy is very effective; only 1-2 out of 1000 couples have a pregnancy in the first year after the procedure.
Who can get a vasectomy?
Any male who is confident he doesn’t want to father another child is a potential candidate. There is no minimum age, but you should be in a stable, committed relationship and your partner should not be pregnant or delivered within the last six months.
I ask my patients considering vasectomy this question “If all your children were to die tomorrow, would you and your wife want to have more children?” Although nobody wants to think of this extreme situation, it is important to remember vasectomy should be thought of as not reversible.
There is a reversal surgery, but Tricare doesn’t cover it and it is not 100 perfect effective. Vasectomy damages the vas deferens and reattaching the two ends is very difficult and may not join the tube perfectly and smoothly back together. The body also forms antibodies to sperm following the vasectomy and those antibodies harm the sperm, making it harder for them to fertilize an egg.
What should I do if I think a vasectomy is right for me?
Vasectomies and pre procedural counseling are offered at Naval Health Clinic Lemoore. The procedure is done in the clinic with local anesthesia, though some providers have their patients take oral sedatives in the waiting room.
A vasectomy takes anywhere from 10 to 25 minutes and requires some serious couch time after the procedure to allow the scrotum to heal. You will be out of work and on the couch for 48 hours and should take it easy for two weeks and wear supportive undergarments to prevent bleeding and swelling.
Because of this, you will need approval from your command before having the procedure.
Several weeks after the vasectomy, you will have a semen analysis to make sure the procedure was successful and you are no longer fertile. You have to use a backup method, like condoms until this analysis is done.
Some couples have the vasectomy before the woman’s current method is stopped to prevent a surprise last pregnancy. It is also important to remember that vasectomy does not protect against sexually transmitted infection-only condoms or abstinence does that.
If you (and your partner if you are in a relationship) think permanent sterilization is a good option for you, discuss the procedure with your PCM.
Lt. Gillian Wackowski, D.O., is a Naval Hospital Lemoore Medical Homeport physician. She is a Family Medicine Doctor on Medical Homeport Gold Team and sees patients of all ages.