When individuals or couples are looking for a permanent birth control option, there are two primary choices: a vasectomy or a tubal ligation. The former is for him, while the latter is for her.
Both procedures involve sterilization, even though both procedures are theoretically reversible through surgery.
With a vasectomy, the vas deferens is cut, which means sperm cannot mix with semen. That prevents a woman from becoming pregnant through sexual intercourse.
During a tubal ligation, the fallopian tubes are either clamped or cauterized to prevent pregnancies from occurring. The eggs are no longer able to reach the uterus for fertilization. Sperm can then no longer move up the tubes to the eggs. Two non-surgical methods are now possible, using a catheter to place small inserts into the fallopian tubes to prevent the eggs from reaching the sperm.
In a purely comparative look at both procedures, the vasectomy is the safer option. It offers a faster recovery period, a higher rate of success, and is less expensive to perform.
Here are some of the additional vasectomy vs. tubal ligation pros and cons to review.
List of the Pros of a Vasectomy vs. Tubal Ligation
1. Vasectomies are one of the most effective forms of birth control.
After the procedure, the risk of pregnancy involving a man with a vasectomy is about 1 in 2,000. That puts the rate at a comparative level to tubal ligation. The pregnancy rate for couples when the man has a vasectomy is below 1%. A majority of men who undergo the procedure have a sperm count of zero with their post-procedure semen analysis. Although pregnancy is still theoretically possible, the chances are extremely small.
2. The procedure is easier with a vasectomy.
Doctors will create one or two small punctures to access the tubes. These are cut, then sealed, which completes the surgery. Most men have their vasectomy performed in an outpatient office, with the total time taking about 30 minutes. General anesthesia is not required, which reduces the amount of downtime experienced. Most men can get through the procedure with a local anesthetic. If there is apprehension, using a Valium or similar relaxant helps.
3. It is reasonably easy to reverse the procedure.
About 500,000 men decide to get a vasectomy each year in the United States. About 30,000 men will decide to reverse the procedure at some point in their lives. Although the procedure doesn’t guarantee a reversal, up to 70% of men see a successful result. Those rates are much higher than they are for tubal ligation, which tends to be treated as a permanent option because of the effort and cost to perform it.
4. There are fewer health risks associated with a vasectomy.
The primary health risk avoided by the vasectomy compared to the tubal ligation is the administration of general anesthesia. About 1-2 people of every 1,000 are partially awake even while given the anesthesia, making them aware of the procedure and experiencing pain from it. There are recovery issues to consider too.
Vasectomies also have lower bleeding and infection risks because the procedure is less invasive than a tubal ligation. Men don’t have vital organs exposed during their surgery either.
5. The cost of a vasectomy is much lower than a tubal ligation.
If a woman receives a tubal ligation, the average cost of the procedure in the United States is more than $6,000. A vasectomy averages about $1,000 instead. Some men can have the procedure performed for around $500. Both options are often covered by health insurance, but even with co-pays and deductibles, the vasectomy comes out ahead from a cost perspective. When viewed only as a form of birth control, over a decade, a vasectomy is one of the cheapest options available today.
If cost is an issue for men, then they should contact their local Planned Parenthood office. The facility charges an average of $100 for the procedure. In Canada, vasectomies are free under the nationalized healthcare system, with doctors being compensated about $60.
6. A vasectomy is a one-time expense.
There are other forms of birth control couples can use to avoid pregnancy, such as condoms or pills. Compared to the cost of them, however, the vasectomy is still the best option. You’re only paying for the procedure once. Every other non-surgical form of birth control requires ongoing costs or carries additional risks which men don’t face after having the tubes for the sperm cut and sealed.
7. Vasectomies do not affect sexual performance or gratification.
Men who receive a vasectomy do not experience negative effects with their libido. 99% of men are satisfied with the results received. Even the orgasm does not change after a successful procedure is performed. Women experience a very different outcome, with some even feeling like their libido is completely repressed.
8. Recovery times are much better with a vasectomy.
Most men recovery from a vasectomy after 24 hours to return back to work. They’re asked to abstain from all sexual activity for about a week. A tubal ligation requires 7 to 14 days for a recovery, with some women needing 4 to 6 weeks, depending upon their health and personal circumstances. Only 1% to 2% of men experience ongoing scrotal pain because of their procedure. Pain, swelling, and bruising are the primary issues experienced after getting a vasectomy.
9. No-scalpel options are available for men too.
Using surgical instruments instead of a scalpel, this version of the vasectomy is less invasive and offers a quicker recovery time. The cost for this option is more, but because it doesn’t expose the vas deferens, there are fewer issues with pain, bleeding, or infection when it is chosen.
During this procedure, the tubes are held with a clamp from the outside of the scrotum. Then the physician will use a needle to make a small hole to access the ducts. Then they are sealed to prevent sperm from being ejaculated. This option offers 5 times fewer infections and fewer blood clots, and usually requires no suturing.
10. It allows women to stop taking hormonal birth control products.
Each woman reacts differently to oral contraceptives or hormone-based birth control products. The most common side effect experienced is an exaggerated mood change. If the male partner undergoes the procedure, then the hormone pills or implants can be stopped, which regulates her emotions better. That also prevents the constant worry about whether or not the pill was taken, or if the implant is working.
11. There is zero risk of an ectopic pregnancy with a vasectomy.
One of the serious risks of a tubal ligation procedure is the development of an ectopic pregnancy. That occurs when a sperm meets with an egg outside of the womb. If it occurs, the result can be a life-threatening circumstance for the woman. When a couple relies on a vasectomy instead, this risk becomes almost zero.
12. You have fewer trips to the pharmacy.
Because a vasectomy reduces (or eliminates) the need to be on a hormonal-based birth control for women, there are fewer trips to the pharmacy and the doctor to fill prescriptions. Even though many birth control products today are low- or no-cost with health insurance plans, the fuel costs and doctor’s fees can still add up over time. Even if you stopped one visit to the doctor per year for your partner as a man, over 10 years’ time, the vasectomy would feasibly pay for itself.
13. It may be a better option for those with religious employers.
In the United States, employers with religious foundations have fought the birth control provision requirements in healthcare since the passing of the Affordable Care Act. Although companies in this position balk at the idea of providing hormonal birth control to women, they will often cover vasectomies. If you find yourself in this type of situation, for better or worse, it may be a cheaper and less stressful option to consider than trying to fill a pill prescription.
List of the Cons of a Vasectomy vs. Tubal Ligation
1. There is still a chance of chronic pain or pregnancy.
Although the success rates of a vasectomy are very high, there are still some men who experience negative outcomes from the procedure. Up to 2% of men suffer from chronic pain because of the procedure, which doesn’t go away even with a reversal. Less than 1% of men who undergo a vasectomy still get their partners pregnant. Reversals are sometimes, but not always, an option, which means the choice is a little more complicated in certain family situations.
2. It does not protect against sexually transmitted disease or infection.
Vasectomies do not protect men against the transmission of a disease or infection through sexual intercourse. Although that issue is the same for women too, some men do go into the procedure thinking that they’ll be completely protected. You must continue practicing safe-sex habits if you engage intimately with multiple partners. The goal of a vasectomy is to prevent pregnancies only.
3. There are long-term health issues to consider.
Although rare, some men do experience a buildup of fluid around their testicles after going through a vasectomy. This issue causes a dull ache for men that worsens when they ejaculate. There can be inflammation in the area from leaking sperm if the tubes are not sealed properly after the procedure. Some men also experience an abnormal cyst that forms in the coiled tube located on the upper testicle.
4. It requires a physician familiar with the process to be as successful as possible.
According to WebMD, when vasectomies are performed by physicians who are experienced, then as few as 0.001% of the procedures performed fail to do the intended job, which is preventing the ejaculation of sperm during an orgasm. That prevents the pregnancy. When the procedure is performed by a doctor who does 50 or fewer per year, even with multiple years of experience, the failure rate can be higher than 17%. Tubal ligations do not have a similar issue with that large of a success gap.
5. The body knows how to heal itself, naturally reversing the procedure.
According to Dr. Michel Labrecque, Professor of Family Medicine at Laval University in Quebec, Montreal, Canada, if a doctor says there is no sperm in the follow-up test, then there is still a small chance that you can become fertile again as the body heals. He recommends that if a pregnancy does occur, the first assumption should be that the man’s body recovered from the procedure instead of assuming infidelity.
Women who receive a tubal ligation experience this issue too. Some women have their tunes “grow back together,” according to Swedish Hospital, which permits sperm to reach the eggs once again.
6. Many men have sperm antibodies form in their blood after a vasectomy.
Sperm normally doesn’t come into contact with the bloodstream. After a man receives a vasectomy, however, there is a 67% risk that antibodies to sperm will form in their blood. That happens because the sperm will leak into the normal tissues of the body after the tubes are cut. Those antibodies target the proteins in the sperm, which have a structure similar to proteins found in the brain. Northwestern University suggested as early as 2006 that this may cause a rare, but plausible, autoimmune attack on the brain.
7. Women may experience a lower risk of ovarian cancer with a tubal ligation.
If there is a family history of ovarian cancer in the family of the woman in a partnership or marriage, then the tubal ligation may be the better option. After a tubal ligation, there may be a decreased risk for the future development of ovarian cancer after the procedure which is not present if the man gets a vasectomy instead.
8. Vasectomies may cause blood in the semen.
Although the issue is somewhat benign, it is scary if it occurs after a vasectomy for me. That’s because secondary causes of having blood in the semen can be an indication of cancer, a prostate infection, tuberculosis, parasitic infections, and liver disease. The added red blood cells to the semen could present rare exposure issues for women who have intercourse with men having this issue as it increases the chances of an infection occurring.
9. A vasectomy creates life impacts should personal circumstances change.
If something happens to a couple in the future, then a vasectomy limits the options to start another family. A tubal ligation does the same. Because most couples only have one person become sterilized, that places the man in a disadvantageous situation. They would be unable to have children with a future partner more often than not, while their wife could start another family. It’s asking for complete trust that could be violated.
The pros and cons of a vasectomy vs. a tubal ligation show that there are many more advantages for couples when the man gets the procedure instead of the woman in the relationship. It is convenient, effective, and a permanent way to manage birth control. Despite that fact, only 9% of sexually active men have had a vasectomy, compared to 27% of sexually active women. Although there are some side effects and rare long-term concerns to think about, most couples find that their sex life is better after recovery because the procedure is extremely effective.