Contraception and Safer Sex
 

Abstinence
Birth Control Pills
Depo Provera
Diaphragm
Emergency Contraception Pill
Female Condom (Reality Condom)
Fertility Awareness Methods
Hormonal Contraceptive Patch (Evra Patch)
Hormonal Contraceptive Ring (Nuva Ring)
Intrauterine Device (IUD)
Intrauterine System (IUS)
Male Condom
Spermicides
Tubal Ligation
Vasectomy
Withdrawal

Vasectomy

What is a vasectomy?
A vasectomy is a surgical procedure that cuts and blocks the tubes (vas deferens) that carry sperm away from the testicles. There are two kinds of vasectomy procedures available in Canada: scalpel and no-scalpel. A vasectomy is considered a permanent method of contraception. 

How does a vasectomy work? 
First the doctor finds the vas deferens (the tube that carries sperm) under the skin with his fingers. The doctor gives you a local anaesthetic to numb the area and then makes a tiny opening in the skin. The vas deferens is lifted out, cut and blocked on both sides and then re-inserted back into the scrotal sac. In a no-scalpel vasectomy, the tiny opening heals quickly on its own without stitches and without leaving a scar. In a scalpel or conventional vasectomy, stitches are put in and take a few days to heal. There may be some swelling and pain for a couple of days that can be treated with anti-inflammatory drugs. Even though a vasectomy is a fairly simple procedure that can be performed in 15-20 minutes, it is recommended that you do not engage in strenuous exercise or lifting for 2-7 days after the procedure and get lots of rest. 

Blocking the vas deferens prevents the release of sperm when you ejaculate. You can still ejaculate during sex, but the fluid doesn't contain any sperm. The lack of sperm in the ejaculate (cum) prevents pregnancy. Males continue to produce sperm in the testicles for the rest of their life, but it is just reabsorbed into the body rather than released into the tube or vas deferens.  

How effective is a vasectomy?
A vasectomy is highly effective in preventing pregnancy. One to two couples in 1,000 will become pregnant within the first year after a vasectomy.  Failure is very rare - this only happens if the tubes are not sealed properly or the tubes grow back together. Pregnancy can also happen if a couple does not use birth control during the 3 month period it takes for a vasectomy to be effective.

* Vasectomy does not protect against sexually transmitted infections *  

How do I use a vasectomy as contraception? 
A vasectomy is considered a permanent form of contraception.  In very few cases, it can be reversed, but the cost is not covered by health care. A vasectomy is usually effective within 3 months (12 weeks) of the procedure, regardless of the number of ejaculations that a man has during that time (it can take longer to get rid of all of the sperm in the tube). You will have to come back to do a sperm analysis test at the doctor’s office after 3 months to make sure that all of the sperm are blocked. After the test is done and it is confirmed that all of the sperm are gone, you can have sex and not have to worry about birth control. 

After the procedure and up until the test confirms the sperm are gone (at least 3 months after the procedure), you can use a backup method of birth control such as condoms and spermicide to ensure that you do not get any female sexual partners pregnant. 

What are the advantages of having a vasectomy?
Permanent
Simple, highly effective procedure with quick recovery time
Does not affect sexual function, e.g., production of semen or ability to maintain an erection
Allows for sexual spontaneity
Fully covered by some provincial health insurance plans (e.g. Ontario Health Insurance Plan)

What are the disadvantages of having a vasectomy?
Does not protect against sexually transmitted infections (STIs)
May not be reversible
Requires a medical procedure and recovery days
Regret can occur if the man decides he wants to have kids again at some point after the surgery
Risk of inflammation, bleeding, infection and very rarely, re-joining or re-canalization of the vas deferens.

How can I get a vasectomy? 
After a simple medical exam to see if the vas deferens (tube that carries sperm) can easily be located and some counselling to make sure that you are ready to make this decision, you can either be referred to an urologist or a family physician that performs the procedure. You can also call a private clinic directly without a referral.  The doctor will confirm that you are sure that you do not want any more children in the future. 

A vasectomy can be performed in a doctor’s office under local anaesthetic or in a hospital. There is no age limit for the procedure but you must give informed consent. 

How much does a vasectomy cost?
The cost of the vasectomy procedure varies by province. For example, the full cost of a vasectomy is covered by OHIP if you obtain a vasectomy within the province of Ontario. If you are a resident of Quebec you will have to pay $55 up front for the first consultation with the doctor and then $120 for the actual procedure. Afterwards, you will be partially reimbursed later by the Régie de l’assurance maladie du Québec.