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 provides one of the most reliable forms of permanent contraception. However, no medical procedure is completely risk free. National data shows that about 1 in 2000 men experience a late failure, which means their partner becomes pregnant after they have already received a negative semen test.
Most surgeons ask men to give a semen sample at 12 weeks after their vasectomy. If the sample shows no live sperm, the patient gets cleared. But testing this early can sometimes give a false sense of security.
My Experience: Over 20,000 Patients Without a Late Failure
I am Dr Martin Kittel, and I have performed over 20,000 vasectomies. In all of these patients, I have never had a late failure. I believe my results come from testing differently and using a more secure surgical technique.
Instead of testing at 12 weeks, I ask patients to provide a sample at 20 weeks. By testing later, I identify men whose vas deferens, the sperm tubes, may have started to reconnect. This later test prevents men from being given the all clear too soon.
A Case That Proves the Point
One of my patients gave a postal sample at 20 weeks. It showed only 30,000 dead sperm, which usually suggests success. However, because postal samples can kill sperm during transport, I repeated the test.
At 8 months, his new sample contained millions of live sperm. This proved that at 20 weeks he was just beginning to reconnect, and the later test caught it.
If we had tested him at 12 weeks, he almost certainly would have been declared clear, and his eventual pregnancy would have been called a late failure. In truth, this was a late early failure, one that testing too early would have missed.
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 cauterise and remove at least an inch of the vas deferens. Many clinics using the so called Marie Stopes method interrupt only about 1 cm.
A longer interruption makes reconnection much less likely.
Rethinking “Late Failures”
Many so called late failures may actually be failures of early testing. If surgeons test at 12 weeks, they may miss patients who are still reconnecting. These men appear clear at the time, but later their fertility returns.
By testing later and by removing a longer section of the vas, I reduce the risk of reconnection and help patients avoid the distress of an unplanned pregnancy.
Conclusion
National figures suggest that vasectomy late failures occur in 1 in 2000 men. In my own practice, with over 20,000 patients, I have recorded no late failures.
By delaying semen testing to 20 weeks and by removing a longer section of the vas deferens, I provide patients with one of the safest and most reliable vasectomy outcomes available.
To learn more about vasectomy click here and scroll down to the second part of the page after the clinic description. To learn more about our clinic click here