Thanks to new microsurgery techniques that have made reversals more successful, San Francisco urologist Paul Turek goes so far as to call vasectomy "the new condom."
Just how reversible vasectomies are is a matter of debate. Until recently, conventional wisdom held that the longer it's been, the harder they are to reverse. That is true to a degree, says Turek, but in the hands of a skilled surgeon, success rates are still quite good.One 2013 study looked at 1,229 vasectomy reversal patients, average age 42, and found that 84 percent had moving sperm in their semen again afterward. If the vasectomy was less than 15 years old that rate was 93 percent; if it was more than 15 years old it was still 75 percent.Those numbers have caught the attention of a small but growing number of young Silicon Valley entrepreneurs who have found their way to Turek's office."These are wealthy, busy, tech industry guys who don't like variables they can't control. They don't want to have to worry about a fingernail puncturing the condom as she puts it on. They want birth control that just works without them having to do anything. And they have the money."
Wade went sheep hunting 48 hours after having his first vasectomy.
Michael Eisenberg, director of male reproductive medicine at Stanford University, says he believes that in the hands of skilled surgeon, like Turek or himself, reversals can indeed be quite successful. The trouble is, there aren't that many skilled surgeons and the delicate three or four-hour microsurgery is highly complex. Turek likens it to hand-stitching a suit in the operating room."I suppose it depends on how you handle risk, but in general I think vasectomy is a better option for men who are done with family building," says Eisenberg.Others note that simply having motile sperm after a reversal doesn't necessarily mean a man can father a child. Sperm counts and sperm health can wane over time and in reality, "take home baby" rates post-vasectomy actually range from 50 to 70 percent.Male contraceptive advocate Lissner finds Turek's "vasectomy as the new condom" idea "provocative" and might even buy it with one key caveat. If she were a guy, she says, she'd bank some sperm before going under the snippers.
Lissner finds Turek's "vasectomy as the new condom" idea "provocative" and might even buy it with one caveat: She'd bank some sperm before going under the snippers.
Five years from now, guys might not have to go to such great lengths. Earlier this year, Lissner and scientists at the University of California Davis published a paper showing that Vasalgel, when injected into the vasa deferentia of 16 adult rhesus monkeys, effectively prevented them from impregnating their mates when housed with three to six females over two breeding seasons. "It worked like nobody's business," says Lissner, who is now moving on to animal trials to see if sterilization can be reversed by washing the polymer out.Meanwhile, a biotech startup called Contraline (of which Turek is a medical advisor) is rushing to get a similar product to market. Company founder Kevin Eisenfrats, a 23-year-old University of Virginia grad who wrote his college essay about the dearth of reliable male contraception, says his approach would be even less invasive than vasectomy or Vasalgel, requiring no incision in the scrotum at all. Instead, doctors would use a needle guided by ultrasound to inject a polymer called Echo-V into the vas. "It would be quick, like getting a flu shot," he says. His goal is to be FDA approved by 2021.That revolution will come far too late for the Wades who, over the years, have spent well over $20,000 on procedures plus travel (to Tacoma, WA, for his first reversal, and to Turek in California for his second). But they have no regrets.Today, they're enjoying springtime in Alaska, hiking, hunting and fishing with their two sons, now 16 and 8 and sneaking off when they can to try to conceive that little girl. "If it happens, it happens—it was meant to be," Shari says. "We're just going with the flow."
"As an 18-year-old man, the smartest decision I can make with my body right now is to have a vasectomy," proclaimed one user in a post that garnered hundreds of responses.