While some men may be sure they do not want children or have enough children, giving up their fertility by having a vasectomy can still be a difficult choice. — dpa
The subject keeps coming up – Heiko Otto’s partner usually broaches it – and with increasing frequency now after the birth of their third child.
The subject is a vasectomy, the medical term for male sterilisation.
“All the other methods of contraception have a drawback, and female sterilisation involves more extensive surgery,” Otto says.
“It’s often the woman who takes responsibility for birth control, which isn’t quite fair.
“My partner would like me to have the procedure.”
But the 41-year-old is undecided. He says he’s still in “the discovery phase”.
“It stirs something up in me,” he explains.
“Not really fear of the surgery itself, although that has a little to do with it.
“There’s just something so final about it.”
Consider it permanent
A vasectomy is the surgical cutting and sealing of the ducts that convey sperm from the testicles to the urethra – the tube that in males carries semen and urine out of the body.
It’s nearly 100% effective, and is by far the safest form of male birth control, according to the Pearl Index, which compares methods of contraception.
The chances of restoring the man’s fertility by surgically repairing his sperm ducts are very good for the first two or three years after the operation, but then steadily drop, according to urologist Dr Marc Armbruster.
”It’s a step that should be seen as permanent,” he says, adding that very few men want to undo it later.
Sometimes, men ask whether a vasectomy has an adverse effect on libido or the ability to have an erection, he adds.
“The answer is no, since only the sperm ducts are cut and not, for example, the nerves involved in an erection.”
If erectile dysfunction or loss of libido do occur, the cause is typically psychological, he points out.
Berlin School of Psychology professor of clinical psychology and psychotherapy Dr Timo Storck says that having a vasectomy can be more difficult on an emotional level than on a physical or mental one, as the man may wonder whether he’ll regret giving up his fertility.
This is what’s on Otto’s mind: “It would really be the end of me having more kids.”
Although three children has always been the number that he and his partner envisioned, he says, “I can’t say with absolute certainty that our family is complete.
“If our financial situation changed, for example, I’d definitely want more kids.”
And then there’s a second scenario: “Should we part ways at some point, which I naturally hope doesn’t happen, then I’d only be able to start another family by having much more extensive surgery, if at all.”
Prof Storck notes that it’s important not to use psychology or morality to tell someone mulling a vasectomy what to do, as “it’s a very personal, individual decision that should to be carefully weighed”.
”Sometimes it can be tied to other questions, such as how the person generally deals with major steps, with committing to something,” he says, adding that another important question is the willingness to undergo a surgical procedure that isn’t medically necessary.
Less stigma
Dr Armbruster has been doing vasectomies for about 15 years.
“When I started, I had the feeling that the patients only told their very best mates about it,” he recalls.
“It was a taboo subject.
“Now they’re more likely to come and say, ‘My neighbour recommended it and a guy in my football club had it done too.’
“Men talk about it much more openly.”
Prof Storck says, “I think it’s sneered at less today than it was 10 or 20 years ago.
“There’s more curiosity about the motives than rejection and ridicule.
“In 10 or 20 years, there’ll be even more openness about it; who knows whether this will lead to more vasectomies?”
The typical vasectomy patient, according to Dr Armbruster, is in his late 30s, has two children and doesn’t want any more.
But a few are younger men who say they have no children and don’t want any.
Men who decide to have a vasectomy should be sure, he says.
“The ones who come to me have made their decision and have no more reservations.”
Otto still needs time to think about it.
If he decides to go under the knife, he says it’ll be mainly for his partner.
“At any rate, the process of reflection isn’t finished for me yet.
“My partner has now ordered the (contraceptive) pill again for the time being.
“But I’m not saying with 100% certainty that I won’t have a vasectomy.” – By Christine Cornelius/dpa
