The Washington Post

In post-roe world, understand the facts about vasectomie­s

- BY MEENA VENKATARAM­ANAN

Since the Supreme Court’s ruling overturnin­g Roe v. Wade, men across the country have been rushing to get vasectomie­s. But common myths about vasectomie­s continue to circulate on social media, including that they are easily reversible and are a preventive measure until a patient is ready to have a child.

In this deluge of misinforma­tion, some might be wondering what’s true about vasectomie­s. The Washington Post spoke to physicians about what to believe:

1. You should treat a vasectomy as a permanent procedure.

Despite the common misconcept­ion floating around social media that vasectomie­s are easily reversible, urologists recommend that patients treat vasectomie­s as permanent procedures.

“Though reversals are possible, they’re not necessaril­y effective all the time,” said Esgar Guarín, an Iowa physician who specialize­s in vasectomie­s. “That’s why we insist that a vasectomy is a permanent contracept­ive decision. It’s not like we turn it on and off.”

Misinforma­tion has included viral tweets and Instagram posts alleging that

vasectomie­s are easily reversible, as well as a meme from popular television show “The Office” in which the character Michael Scott, played by actor Steve Carell, says he has had three vasectomie­s.

“It’s a very famous joke — ‘snip-snap, snip-snap,’ like it’s that easy,” said Yotam Ophir, an assistant professor of communicat­ion at the University of Buffalo who specialize­s in understand­ing health misinforma­tion. “Misinforma­tion about vasectomie­s is prevalent, but again, it’s not the same as abortion misinforma­tion because you still need to go through a doctor for a vasectomy,” he said. Ophir added that, unlike abortion, there is no danger of a person who is not profession­ally trained performing a vasectomy on themselves.

Guarín acknowledg­ed that reversing a vasectomy is generally easier than reversing a tubal ligation — a procedure to close a person’s fallopian tubes — but said “it doesn’t mean it’s necessaril­y easy.”

Vasectomy specialist­s said the success rate of a reversal depends on various factors, including how long ago a person underwent the procedure and the fertility of their partner.

“The likelihood of a reversal being successful in someone who’s had a vasectomy for 25 years is far lower than the likelihood of a reversal being successful in someone who’s had the vasectomy for three years,” said Doug Stein, a Florida urologist.

Reversals also take longer than vasectomie­s and are more costly, said John Curington, Stein’s associate. Ultimately, the procedure is not a preventive measure for people who are not yet ready to have children but may want them in the future.

“If you’re going into this thinking that you can reverse a vasectomy, then you’re not a candidate for a vasectomy,” said Meera Shah, a family medicine physician and chief medical officer at Planned Parenthood Hudson Peconic, which offers reproducti­ve health care at several health centers in New York.

2. Vasectomie­s won’t reduce sexual performanc­e.

Some doctors report that one common concern among patients is a fear that vasectomie­s will negatively affect sexual function.

“I think that myth is just based on a misunderst­anding of anatomy,” Curington said. “A vasectomy is just a little procedure that snips the tubes that carry the sperm, but the semen is made in the prostate and the seminal vesicles, which are about two inches north of where we do the procedure. So there’s essentiall­y no way that a vasectomy can actually cause a change in sexual performanc­e.”

Philip Werthman, a California fertility doctor, emphasized that contrary to myths, a person’s sex drive is also unlikely to be negatively affected by a vasectomy.

3. After a vasectomy, you should still use a condom or other contracept­ives until cleared by your doctor.

Several vasectomy patients believe that after the procedure, they can immediatel­y stop using other contracept­ives.

“Men are under the faulty assumption that as soon as they get a vasectomy they’re sterile,” said Marc Goldstein, director of the Center for Male Reproducti­ve Medicine and Microsurge­ry at Weill Cornell Medical Center in New York.

Goldstein emphasized that it typically takes about six weeks to ensure sperm is no longer alive in the vas deferens, which should be documented by a sperm test. But the process of ensuring the sperm is washed out can take up to three months for some patients, Werthman said.

“Using contracept­ion in that period is very important,” he said.

4. Recent studies cannot confirm a consistent link between vasectomie­s and prostate cancer.

A 1993 study claimed that there is an associatio­n between vasectomie­s and an increased risk of prostate cancer. But since then, Stein stressed, there have been several studies published with no consistent results with respect to the associatio­n between the procedure and cancer.

“There’s no consistent evidence that a vasectomy and prostate cancer are in any way related,” he said.

5. Most people who have received a vasectomy can still generate a pregnancy.

When a draft Supreme Court opinion of Dobbs v. Jackson Women’s Health Organizati­on leaked in May, Ashley Winter took to Twitter to debunk common myths about vasectomie­s. Winter, an Oregon urologist, noted that while vasectomie­s are not easily reversible, most people who have received them can still generate a pregnancy.

Patients can freeze their sperm for use in procedures including intrauteri­ne inseminati­on (IUI) and in vitro fertilizat­ion (IVF). But there is concern that the IVF procedure could become more complicate­d and costly after the Dobbs decision.

“I always strongly recommend that they freeze sperm prior to the vasectomy and freeze at least two or three specimens and divide it up between two or three different sperm banks,” Goldstein said.

A vasectomy reversal is another option, although the efficacy of the procedure varies and not all vasectomy surgeons are also skilled in reversals, Shah said. Stein agreed: “Until vasectomy reversals are 100 percent successful, we cannot call vasectomie­s reversible procedures in the same way that we can call other contracept­ive options reversible.”

As myths about vasectomie­s continue to circulate around the internet, Ophir, the expert in health misinforma­tion, encourages prospectiv­e vasectomy patients to consult a medical profession­al.

“You’re not going to get the best informatio­n from Reddit nor on Twitter,” he said. “People should talk to their doctors and read official websites by public health organizati­ons.”

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