• Posted August 31, 2023

More American Men Now Opting for Vasectomy

Vasectomies are becoming more common in the United States, with rates surging by more than one-quarter during the past decade, a recent study reveals.

The U.S. vasectomy rate increased by 26% between 2014 and 2021, according to an analysis of commercial health claims data.

"All areas in the United States except the Northeast showed increased vasectomy rates,"said senior researcher Dr. Omer Raheem. He is an assistant professor of surgery-urology with the University of Chicago School of Medicine.

Overall numbers remain low, with roughly 4% of men having undergone vasectomy, the researchers noted.

But doctors expect the demand for vasectomy will continue to increase following the 2022 Supreme Court decision that abolished the national right to abortion.

"After the Roe v Wade overturn, there has been a significant increase in Google searches for vasectomy, as well as an uptick in vasectomy consultations and procedures,"said Dr. Stanton Honig, division chief for reproductive and sexual medicine at Yale School of Medicine, in New Haven, Conn.

"This recent study points to the fact that men are taking more of a role in reproductive health and family planning, especially when they are finished having children,"continued Honig, who was not involved with the new research.

For the study, Raheem and his colleagues gathered health insurance claims data to calculate the annual vasectomy rate among privately insured men in the United States, aged 18 to 64.

The percentage of all male patients undergoing vasectomies in a given year increased from about 0.43% in 2014 to 0.54% in 2021, the investigators found.

The relative increases were greatest in men with no children (61%), men with an older wife (41%), single men (41%), and young men 18 to 24 (37%).

Vasectomy also remained a popular option for men with two or more children, the results showed.

Rural areas experienced greater increases in vasectomy rates than urban areas, the researchers added.

"Given the political landscape, some men are leaning in and taking more responsibility to prevent unintended pregnancy,"said Dr. Monica Dragoman, system director of the complex family planning division in the department of obstetrics, gynecology and reproductive science at Mount Sinai School of Medicine in New York City.

"The reasons are deeply personal and multifactorial, but motivations can include concerns for their partner and fear about having kids they don't want,"Dragoman said. "Unfortunately, there are few highly effective methods other than vasectomy available to men."

One reason for the uptick likely is that vasectomies have become so easy to undergo, Honig said.

"A vasectomy is a minimally invasive, office-based procedure and takes about 10 minutes to perform. The patient walks in and out, as it is done under local anesthesia,"Honig said.

Vasectomies also are increasingly seen as reversible procedures, Raheem added.

"With the surge of vasectomies, we also see a surge, not mirror image, but we also saw a surge of vasectomy reversals,"Raheem said. "I expect to see more men asking for reversal of vasectomies in years to come."

However, Dragoman warned that men shouldn't count on an easy reversal, particularly if they've had their vasectomy for a while.

"Following vasectomy, successful pregnancy following a reversal is a possibility. However, this likelihood decreases over time and there is no guarantee of pregnancy,"Dragoman said. "People pursuing vasectomy with the idea that they will reverse when they are ready for childbearing are probably not the right candidates for the procedure."

Vasectomy has become a common enough procedure that there are even awareness campaigns for it timed around the March Madness basketball tournament, Raheem noted.

"Because men are watching TV, they have more rest time, so they choose to have it done around March Madness,"Raheem said.

The number of vasectomies could have been even greater during the time period in question, Raheem said, except that there's a nationwide shortage of urologists available to provide counseling and perform the procedure.

"I think it's essential for us as we plan ahead for the next years to come to be aware of these trends of vasectomy nationally and be more proactive about offering vasectomy counseling and services to meet this growing need for patients,"Raheem said.

Despite this increase, however, tubal ligation in women remains more popular than vasectomies in men, Honig and Dragoman noted.

"Everyone is feeling the impact of abortion restrictions. On one hand, I think it is a positive thing that some men are being more proactive about pregnancy prevention,"Dragoman said.

"However, this method remains underutilized compared to permanent female contraception, even with relative increases in demand for the procedure,"she continued. "It will be interesting to see if short-term trends translate to long-term changes in how men participate in sharing contraceptive responsibilities."

The new study was published recently in the journal Urology.

More information

Planned Parenthood has more about vasectomy.

SOURCES: Omer Raheem, MD, assistant professor, surgery-urology, University of Chicago School of Medicine; Stanton Honig, MD, division chief, reproductive and sexual medicine, Yale School of Medicine, New Haven, Conn.; Monica Dragoman, MD, MPH, system director, Complex Family Planning Division, Raquel and Jaime Gilinski department of obstetrics, gynecology and reproductive science, Icahn School of Medicine at Mount Sinai, New York City; Urology, June 21, 2023