Vasectomy is considered the most effective and successful procedure. Despite the effectiveness of vasectomy, there are chances that your partner can still get pregnant. Vasectomy failures are very exceptional and rare, but they are not foolproof.

This article explains why vasectomy fails and what the importance of vasectomy testing is. Let’s take a look at vasectomy.

What Is A Vasectomy?

Vasectomy is a surgical procedure used for permanent contraception of men. It is used to stop male fertility. Vasectomy stops the sperm from reaching semen by cutting or blocking each vas deferens.

Getting a vasectomy doesn’t mean that testes will not make sperm. Semen still holds sperms, but either the sperms die, or the body absorbs them.

The procedure is considered to be permanent because after vasectomy is done, you cannot reverse it. The reversal of vasectomy is costly and usually does not give positive results. Because once it’s done, restoration of sperm count and sperm motility cannot be achieved.  

But we must not neglect the other side of the story. We must keep in mind that failure can happen because vasectomy is not always 100% effective [1]. 

 

Vasectomy Failures:

Vasectomy is believed to be an efficient birth control procedure, but there are chances of failure. According to a research study, one in a thousand men can face or experience vasectomy failure [2].

Failures are rare, but there are three main reasons for it to happen that are described below:

• Intercourse Too Soon:

The basic reason behind failure is that a couple resumes sexual activities shortly after surgery. It takes time for semen to be sperm-free. Several months are required in this process, and a semen test is important to ensure that it is sperm-free.  

So, intercourse right after surgery can transfer sperm into the female body and results in an unwanted pregnancy. The couple should adopt another birth control method to avoid pregnancy until the zero sperm count [3].

• Snipped Tubes Reconnect:

Vasectomy includes the detachment or cutting of the vas deferens tube so that it cannot transport sperms. But there are very rare chances of automatic reconnection of the detached tubes. This occurs when a small channel is produced between scar tissues that allow sperms to reach out to semen.  There is no time limitation about the reconnection of snipped tubes, as it can happen any time after surgery, but it usually happens shortly after surgery. 

• Surgical Error:

Errors during surgery can lead to vasectomy failure. Although the procedure is quite simple, if the vas deferens tube is not sealed properly after a small cut, it can cause vasectomy failure. Anatomical variations in patients can be a reason for surgical errors too. 

• Previous Surgery:

If the patient has previous surgeries in the same area, then vasectomy will not work efficiently, thus increasing the chances of failure.

 

Importance Of Semen Testing:

Semen testing after getting a vasectomy is the most appropriate practice to avoid failures and unwanted pregnancies. However, more than 50% of men never check their sperm count after vasectomy. Semen testing after vasectomy is essential to ensure the complete absence of sperms in semen (azoospermia) [4].

Why and how we should conduct testing is described below in a brief way:

• A semen test is important to ensure the zero-sperm count in the sample.

• It helps in avoiding any kind of inconvenience such as unwanted pregnancy.

• Semen should be tested after three months of vasectomy because semen takes three months to be sperm-free after the surgery.

• Semen samples should be collected and submitted to the laboratory.

• Other types of birth control should be used in the meantime before getting positive semen test results means zero sperms [5].

 

 

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References: 

[1]         Schwingl PJ, Guess HA. Safety and effectiveness of vasectomy. Fertil Steril 2000;73:923–36. https://doi.org/https://doi.org/10.1016/S0015-0282(00)00482-9.

[2]         Kern T, Artenstein D, Shapiro C. Postvasectomy Scrotal Pain and Hematospermia, a Possible Harbinger for Vasectomy Failure and Recanalization: A Case Report. Perm J 2019;24:19.068. https://doi.org/10.7812/TPP/19.068

[3]         Abbe CR, Page ST, Thirumalai A. Male Contraception. Yale J Biol Med 2020;93:603–13.

[4]         Jamieson DJ, Costello C, Trussell J, Hillis SD, Marchbanks PA, Peterson HB, et al. The Risk of Pregnancy After Vasectomy. Obstet Gynecol 2004;103.

[5]         GRIFFIN T, TOOHER R, NOWAKOWSKI K, LLOYD M, MADDERN GUY. HOW LITTLE IS ENOUGH? THE EVIDENCE FOR POST-VASECTOMY TESTING. J Urol 2005;174:29–36. https://doi.org/https://doi.org/10.1097/01.ju.0000161595.82642.fc.

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