Are We Testing Too Early After Vasectomy?
The Standard Approach in the UK
Are We Testing Too Early After Vasectomy?
The Standard Approach in the UK, US and other parts of the world
Vasectomy is known as one of the most dependable methods of permanent
contraception. Still, it’s important to remember that no medical
procedure is entirely without risk. National statistics indicate that
about 1 in 2000 men may experience a late failure, which means their
partner could become pregnant even after receiving a negative semen
test.
Typically, surgeons request that men provide a semen sample 12 weeks
post-vasectomy. If the sample reveals no live sperm, the patient is
given the green light. However, testing this early can sometimes create a
false sense of security.
My Experience: Over 20,000 Patients Without a Late Failure
I’m Dr. Martin Kittel, and I’ve performed more than 20,000 vasectomies.
Remarkably, I’ve never encountered a late failure among my patients. I
attribute my success to a different testing approach and a more reliable
surgical technique.
Rather than testing at 12 weeks, I prefer to have my patients submit a
sample at 20 weeks. This later testing allows me to catch any men whose
vas deferens, the tubes that carry sperm, might be starting to
reconnect. By waiting, I can prevent men from being prematurely cleared.
A Case That Proves the Point
One of my patients sent in a postal sample at 20 weeks, which showed only 30,000 dead sperm—typically a sign of success. However, since postal samples can damage sperm during transport, I decided to repeat the test.
When I tested again at 8 months, his new sample revealed millions of live sperm. This confirmed that at 20 weeks, he was just beginning to reconnect, and the later test caught this issue.
Had we tested him at 12 weeks, he would likely have been declared clear, and any subsequent pregnancy would have been labelled a late failure. In reality, this was a late early failure, one that early testing would have overlooked.
Why My Technique Lowers the Risk of Failure
Two main factors explain why my patients avoid late failures:
Later Testing
Testing at 20 weeks instead of 12 weeks ensures I detect patients who are starting to reconnect.Longer Vas Interruption
During surgery, I make sure to cauterize and remove at least an inch of the vas deferens. Many clinics that follow the so-called Marie Stopes method only interrupt about 1 cm. A longer interruption significantly decreases the chances of reconnection.
Rethinking “Late Failures”
Many of the so-called late failures might actually stem from shortcomings in early testing. If surgeons only check at 12 weeks, they could overlook patients who are still reconnecting. These men might seem clear at that moment, but their fertility can return later on.
By conducting tests later and excising a longer section of the vas, I minimize the risk of reconnection and help my patients steer clear of the anxiety that comes with an unexpected pregnancy.
Conclusion
National statistics indicate that late failures after a vasectomy happen in about 1 in 2000 men. In my practice, which has seen over 20,000 patients, I haven’t recorded any late failures.
By postponing semen testing to 20 weeks and removing a longer segment of the vas deferens, I’m able to offer my patients one of the safest and most dependable vasectomy outcomes out there.
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