To vasectomy or not to vasectomy...

[Marquand]

I'm currently pregnant with DC3. I'm 43, and DP is 46, so in both our minds this is definitely the last one.

I would like DP to have a vasectomy - I really don't want to use the pill in future, and I'm not too keen on condoms either.

He said a straight out NO when I asked him. I really don't think it's an unreasonable request.

What do you think?

That it's his body his choice.

Do not get confused that just because it's often done under local, it's a risk-free procedure. Look at the NHS Choices page - there is a 1:10 chance of the serious, potentially untreatable long-term complications.

If he does not want to run that risk, that is his decision and his decision only.

I don't think it's an unreasonable request. No medical procedure is without risk, and tbh I think that it's unreasonable for a man to just say a flat no when his wife has carried and birthed his children. I get that it's his decision, but it should really be a 'I don't want to, but I'll research and consider it because you're right it's the best option for us' type conversation.

I may be biased though - DH has been referred for one this morning and we'll book a suitable date later on.

1:10 chance of the serious, potentially untreatable long-term complications. This isn't true. If it was, they wouldn't do the surgery.

The 1:10 chance is for long-term testicular pain. About which, NHS choices says For most men, however, any pain is quite mild and they do not need further help for it.

OP, for what it's worth, my DH initially said a flat no. I asked him to research what else we could do. I lose my sex drive on hormonal contraception, and DC3 was the result of a split condom.

Then he researched it and suggested (as if it were his idea ) a vasectomy.

His body so you can't make him have a vasectomy. Your body so you don't have to go on the pill (or any kind of contraception). That leaves you with three choices:

1. One of you relents
2. You risk having more children by not using contraception
3. You stop having sex

It isnt risk free. From the NHS website: Long-term testicular pain affects around one in 10 men after vasectomy.

It is a minor operation but not a risk free one.

That's the biological difference though. Men can't bear children and should not be expected to have surgery as some sort of payback price tag.

Taking turns with reversible contraception is one thing.

But the surgical removal of fertility is not the same as that either. The risks of laparoscopic female sterilisation tend to be thought of as much higher than they are, and of course GA is not required for the new Essure procedure. And the risks of vasectomy tend to be underestimated, and they are certainly less talked about.

Yes, I agree that the best decisions about the control of future fertility are best taken as a couple together weighing up all the factors. But if one person does not want their fertility permanently removed by surgery, then that decision has to be respected no matter how inconvenient the other person might find it.

DH always said he would have the snip once we were done and he did just that after DC3.

Whilst I agree you can't force him, I would want to know what his objections were and whether he had actually done any research into it. Also what his ideas were for preventing future pregnancy. Don't let him make this YOUR problem

no matter how inconvenient the other person might find it In my marriage it was an inconvenience to both of us , though. Surely it is for many?

His vasectomy was the best thing we did for our sex life. We went back to humping like bunnies.

My dp said he would "think about it", when my coil went out of date (I have problems having it inserted) but when asked a few weeks later he hadn't. Later he said he didn't really fancy it.
I left it, his body, his choice. He's younger than me. He has a child, I have none (but am 47 so no intention of now). He does say he doesn't want any more.
We used condoms for a year or so.
Then I started to sort out my coil.......which was all a nuisance, took ages, involving private appointments and then a long NHS wait.
Meanwhile dp said he would get the vasectomy if he could freeze his sperm........ This upset me as it implied he wanted more children, which he cant have with me.
I just carried on sorting out the coil.
Then one day he said he'd called the doctor and booked the vasectomy and it was in two weeks. And then he had it done.
Was over a year since I'd first mentioned it.

I still had the coil changed as I'd started down that route and it was too late to stop plus it manages my periods.

So, I'd say, leave him to think about it longer.

The op was nothing at all. There wasn't even a cut, they made a small hole, pulled the vas out and cauterised it. Took ten mins, including the cup of tea. He only felt the needles from the local anaesthetic. I don't think the risks are as high with that type so it's worth looking into whether they do that type

For contrast, I had to have a GA for my coil change, which has far higher risks.

Actually, some of the research papers put the risks of PVPS rather higher than 10%, but I've quoted that figure as it's the one the NHS publishes.

Severely affected men (ie those where the level of pain has lasted over 3 months and prevents sex or interferes with the quality of day to day life) cannot necessarily be treated and the condition becomes long term.

If only mildly affected, conservative measures such as scrotal support, heat or cold therapy, and anti-inflammatory medications can be tried. Not fun to live with aching balls all the time for years, but not classed as 'severe'.

But for the severe cases further surgical treatment is all that remains eg microsurgical denervation of the spermatic cord, vasovasostomy, epididymectomy, and inguinal orchiectomy. Vasovasostomy (vasectomy reversal) is an effective intervention for some.

There are fairly serious complications such as like granulomas and haemotomas as well, but they are treatable.

There are no reliable indicators to predict which men will get complications, and of course for 90% of men it's fine and they are back to their normal selves in a month or so (can be much less). But 10% won't, and if a man does not want to undergo a procedure with that level of risk attached, that is his choice and it needs to be respected.

Somerville

I meant the refusal to have surgery to fit another person's preferences as the inconvenience. As your DH had a vasectomy, that doesn't seem to apply to you.

(BTW, my DH has has a vasectomy. If you have a trouble free one, yes, they're great. But for 10% of people having one. The outcome is not great)

Scaevola - Having surgery to fit another person's preference would be problematic, I agree.

The situation you're often in as a couple though, is that every other method of contraception hasn't worked. In which case there is a massive inconvenience of not being able to have sex without a high risk of pregnancy.

My DH was a mathematician and once he got past his initial no and looked at all the studies, he felt that the risks of side effects were hugely outweighed by the guaranteed outcome of not going ahead (No PIV, since I'd been advised not to have another pregnancy).

Obviously everyone needs to do that for anything invasive, but I do think a loving partner should, where other contraception isn't working, and not just say a flat no without looking into it. And, if it is still a no, come up with another alternative.

I'm in a new relationship now so contraception is once more on my mind.

OP has not said that there are reasons why she should not be sterilised (if permanent surgical removal of fertility from one of the couple is her preferred option) nor has she said further PGs are life threatening so it must be quite different circumstances you yours Somerville

And of course there's no reason to expect her DH to have the same attitude to bodily risk as yours.

The OP asked what we thought. I said what I thought.

The other stuff only came up when I replied to you. But it's still on-topic.

And of course there's no reason to expect her DH to have the same attitude to bodily risk as yours.

No, clearly not. I didn't say he should. Just that I think there shouldn't be a flat no without researching it. And if it's still a no, that other alternative should be his problem too, not just hers (since it takes two people to have sex).

It's not unreasonable for you to ask him if he's reconsidered, if/as other forms of contraception or the risk of pregnancy become more of a health issue for you.

It's not unreasonable for him not to want to risk the long term adverse effects that affect around 10% of men who undergo a vasectomy.

If he's still certain he doesn't want to have the snip, it's not unreasonable for you to ask what alternative contraception methods he has in mind.

It's not unreasonable for you to then rule out any proposed alternatives that carry a health risk or cause discomfort to you.

It is unreasonable of you to rule out any alternatives that you "don't much like" or "aren't keen on" where there is no actual risk of harm to either of you.

I asked DH to consider it but his rsearch led to the chronic pain complication and I completely understand so haven't pushed it - I suffer chronic pain following the pregnancies and it's life ruining, I need him healthy and pain free. The pain complication appears to be an issue for women too, especially essure. I'm tempted to go for sterilisation as the risk of pregnancy to my health is higher.

I asked dh to have a vasectomy after our 2nd child. He refused so I insisted on condoms every time. DH didn't like the lack of spontaneity plus I was often on edge as we conceived both dc first month after stopping the pill. Eventually he made the decision to get the vasectomy and everything has been fine since

Me and my husband have discussed this. He doesn't want it as he has a fear of hospitals. That's fine. His choice. I may consider sterilisation or we'll use other contraception.

It's not necessarily done in a hospital, my dh had his done in the local clinic, he's always had a high sex drive, but since the vasectomy he's off the charts lol

Ds had his done when he was 30, best thing ever, did have a big infection afterwards but you can with any operation.

DH not ds

DH initially said no. I said that's fine but was clear I wasn't putting myself through the pill again (hideous side effects) or risking early death with another complicated pregnancy (I had undiagnosed preeclampsia with DD2 and almost died).

Our sex life did take a hit for while until and he accepted to look into it seriously rather than a flat no (which was the part that annoyed me most). He got it done when DD2 was six months.

Someone up thread said don't let him make it YOUR problem, it's both your responsibilities. Depends on how good you can hold your resolve.

I was done 4-5 years ago. A couple of weeks discomfort and that was it. Same with nearly all my mates who have had it done. I know one mate who had a serious infection, but no one I know has had a long-term problem, and as we are in our 40 now most of my mates have been done.

I have know idea where some of the stats quoted above are coming from, but given the risks women take to have kids, some men sound like they need to grow a pair. And then get them snipped.

I will say that if they don't give you enough local anaesthetic the surgeon will find out a few thousandths of a second after the patient does though

If you want a good laugh, do a search for "vasectomy" or "snip" on the Singletrack cycling forum, its a regular topic given their demographic!

No idea, not know

Also see if you can find the vasectomy episode of the Home Improvement comedy show online. Absolute comic gold but might persuade reluctant men to think about it seriously. Not necessarily for the right reasons....