Male sterilization, or vasectomy, is a procedure performed on a man that will permanently keep him from being able to get a woman pregnant.

Vasectomy is an outpatient procedure done under local anesthesia. After the local anesthesia is injected, the health care provider then makes tiny cuts (incisions) in the scrotum, the sac that holds the testes or “balls.” The vas deferens, two tubes that carry sperm to the penis, are then cut, tied or blocked.

Some men receive a no-scalpel vasectomy where, instead of cutting the skin of the scrotum, very tiny holes are made. The tubes that carry sperm are pulled through the holes and tied off and cut. A no-scalpel vasectomy does not require stitches.

After a vasectomy, a man will still produce semen, the fluid that comes out of his penis when he has sex. A man will need to return to his health provider after about three months to be tested to make sure there are no more sperm in his semen. It takes about three months to clear the sperm out of the system. A man should use another type of birth control (like a condom) until his health care provider tells him there are no longer any sperm in his semen.

There may be surgery available to reverse a vasectomy, but men should consider the procedure permanent. Before a vasectomy, men can also freeze their sperm for future use if they choose.

Out of 100 women each year whose partner has had a vasectomy, less than one may get pregnant.

• The man’s partner doesn’t have to know about it or do anything different.

• Lifts the contraceptive burden from the woman

• Safe and highly effective approach to preventing pregnancy

• Lasts a lifetime, so no need to worry about birth control again

• The procedure is simple to do and usually involves only a little bit of discomfort.

• Quick recovery time after the procedure

• Most cost-effective of all birth control methods

• Provides no protection against sexually transmitted infections (STIs), including HIV.

• Requires a visit to a clinic or medical office.

• Risk of swelling, bruising, and tenderness for a short time after the procedure

• Very rarely, the tubes that carry sperm can grow back together. When this happens there is a risk of pregnancy.

• Some men, or their partners, later change their minds and wish they could have a child or additional children.

No. After vasectomy, a man will look and feel the same as before. He can have sex the same as before. His erections will be as hard and last as long as before, and ejaculations of semen will be the same. He can work as hard as before, and he will not gain weight because of the vasectomy.

Some men report having chronic pain or discomfort in the scrotum or testicles that can last from 1 to 5 years or more after a vasectomy. In the largest studies, involving several thousand men, less than 1% reported pain in the scrotum or testicles that had to be treated with surgery. In smaller studies, of about 200 men, as many as 6% reported severe pain in the scrotum or testicles more than 3 years after the vasectomy. In a similar group of men who did not have vasectomies, however, 2% reported similar pain. Few men with severe pain say that they regret having the vasectomy. The cause of the pain is unknown. It may result from pressure caused by the build-up of sperm that has leaked from an improperly sealed or tied vas deferens, or from nerve damage. Treatment includes elevating the scrotum and taking pain relievers. An anesthetic can be injected into the spermatic cord to numb the nerves to the testicles. Some providers report that surgery to remove the painful site or reversing the vasectomy relieves the pain. Severe, long-lasting pain following vasectomy is uncommon, but all men considering a vasectomy should be told about this risk.

Yes, for the first 3 months. If his partner has been using a contraceptive method, she can continue to use it during this time. Not using another method in the first 3 months is the main cause of pregnancies among couples relying on vasectomy.

Yes. A provider can examine a semen sample under a microscope to see if it still contains sperm. If the provider sees no moving (motile) sperm, the vasectomy is working. A semen examination is recommended at any time after 3 months following the procedure, but it is not essential.

If there is less than one nonmotile sperm per 10 high-power fields (less than 100,000 sperm per milliliter) in the fresh sample, then the man can rely on his vasectomy and stop using a backup method for contraception. If his semen contains more moving sperm, the man should continue to use a backup method and return to the clinic monthly for semen analysis. If his semen continues to have moving sperm, he may need to have a repeat vasectomy.

Every man having a vasectomy should know that vasectomies sometimes fail and his partner could become pregnant as a result. He should not make the assumption that his partner was unfaithful if she becomes pregnant. If a man’s partner becomes pregnant during the first 3 months after his vasectomy, remind the man that for the first 3 months they needed to use another contraceptive method. If possible, offer a semen analysis and, if sperm are found, a repeat vasectomy.

Generally, no. Vasectomy is intended to be permanent. In rare cases, however, the tubes that carry sperm grow back together and the man will require a repeat vasectomy.

Generally, no. Vasectomy is intended to be permanent. People who may want more children should choose a different family planning method. Surgery to reverse vasectomy is possible for only some men, and reversal often does not lead to pregnancy. The procedure is difficult and expensive, and providers who are able to perform such surgery are hard to find. Thus, vasectomy should be considered irreversible. 

Each couple must decide for themselves which method is best for them. Both are very effective, safe, permanent methods for couples who know that they will not want more children. Ideally, a couple should consider both methods. If both are acceptable to the couple, vasectomy would be preferable because it is simpler, safer, easier, and less expensive than female sterilization.

Provide clear, balanced information about vasectomy and other family planning methods, and help a man think through his decision fully. Thoroughly discuss his feelings about having children and ending his fertility. For example, a provider can help a man think how he would feel about possible life changes such as a change of partner or a child’s death.

No. There is no justification for denying vasectomy to a man just because of his age, the number of his living children, or his marital status. Health care providers must not impose rigid rules about age, number of children, age of last child, or marital status. Each man must be allowed to decide for himself whether or not he will want more children and whether or not to have a vasectomy.

No. Evidence from large, well-designed studies shows that vasectomy does not increase risks of cancer of the testicles (testicular cancer) or cancer of the prostate (prostate cancer) or heart disease.

Yes. Vasectomies do not protect against STIs, including HIV. All men at risk of STIs, including HIV, whether or not they have had vasectomies, need to use condoms to protect themselves and their partners from infection.

If no pre-existing medical conditions require special arrangements, vasectomy can be performed in almost any health facility, including health care centers, family planning clinics, and the treatment rooms of private doctors. Where other vasectomy services are not available, mobile teams can perform vasectomies and any follow-up examinations in basic health facilities and specially equipped vehicles, so long as basic medications, supplies, instruments, and equipment can be made available.