Daily Archives: 14/10/2013

Our Contraception Journey Part 2: Sterilisation

Getting the Snip

Part 2 of a weekly series. We’ve been through nearly every available contraception method in our efforts to find the right solution for us.

Originally published October 26, 2012

Here is the introduction I wrote then: 

My boyfriend (now SilverHubby) has decided to get a vasectomy, and I am taking advantage of his pain the experience to write a series of articles about it for SexIs Magazine. Part One discusses how we made the decision that surgical sterilization was the right decision for us.

The surgery is in two weeks. Stay tuned then for the boyfriend’s SilverHubby’s words on how it all goes for him on the day. Hopefully it will be more than just “ow ow ow”.

Part three (and perhaps subsequent parts) will discuss the longer term effects of his vasectomy on our sex life and our relationship.

Click on the diagram to see a photo of my boyfriend’s SilverHubby’s cock and balls, before the vasectomy.

Things went very differently than we expected. But more on that later. Here’s the article as it was written then:

About Surgical Sterilization

I am forty-two years old. I haven’t been able to use hormonal birth control for years because it triggers migraines. I tried the IUD, but my body wouldn’t adapt to it and I had to have it removed. My remaining contraception options were barrier methods (i.e. diaphragm, cervical cap, or condoms) or surgical sterilisation.

Surgical sterilisation for females is known as tubal ligation. Most commonly, the patient is put under general anaesthesia. Two incisions are made, through which the surgeon will access each of the fallopian tubes. The tubes will be cut and sealed, either by burning or by using clips. The patient is considered sterile after her next menstrual period. Another method is to access the tubes through the vagina and cervix, and insert implants that will cause scar tissue to develop around them and block the tubes. In this case, it takes 3-6 months for the scar tissue to form, and for blockage to be confirmed by x-ray.

For males, the process is called vasectomy. Under local anaesthesia, two small incisions will be made in the scrotum and the surgeon pulls out a loop of vas deferens. Each tube will be cut and sealed with an electrical instrument, or alternatively a small section will be removed and the cut ends tied shut. The process takes about an hour, and the patient can go home right away. He is considered sterile after two successive negative sperm counts, about a month apart. This generally takes 20-25 ejaculations to clear his system of all active sperm.

With either form of surgical sterilisation, the goal is to put up a roadblock that keeps sperm and egg from reaching one another. Though it is possible to attempt reversal, in the case of regrets, it is likely to be unsuccessful. Getting surgically sterilised should be considered permanent.

As with all surgeries there are risks of complications, but the risks are higher for female sterilisation. The fallopian tubes are deeper inside the body, which makes the surgery more invasive. Both methods have the risk of failure (0.3% for males and 0.5% for females), where the cut ends of the tubes find each other and heal. Either failure could result in an unplanned pregnancy, but if it is a failure in the female’s body, then there is an increased chance that the pregnancy will be ectopic – a situation that is life threatening for the pregnant woman. There is a very low chance that this would happen, but it should be part of the consideration when a couple is considering surgical sterilisation.

Making the Decision

As a couple, we considered it together. And having considered it together, we decided to consider it separately. We wanted to make the decision that was right for us, but we also needed the decision to be completely acceptable to whichever of us was having surgery. We agreed that neither of us would put pressure on the other to be the one who was sterilised. We both believe a person should have full and free choice over their own reproductive system, whether that person is male or female.

I made my decision first, and my decision was no. The only exception is that if I ever needed surgery for some other reason and it was possible to tack on a tubal ligation at the same time, then I would do it.

He took longer to make his decision. He wasn’t prepared to say yes, but he didn’t rule it out. When we went from a long-distance relationship to live in lovers, the increased frequency of sex (and therefore of condom use) seemed to help him make the decision. We had gotten to the point where we were having anal sex more often than vaginal simply to avoid having to use condoms. Finally he told me he was going to do it.

We live in the UK, so everything goes through the National Health Service (NHS). He spoke to his GP, who made a referral. They sent him some paperwork explaining everything he’d already learned by doing his own research, and phoned him to make an appointment. The NHS is infamous for long wait times, but in this case from the time of his first speaking to the GP to his appointment date was just over six weeks.

His vasectomy appointment is in two weeks. There’s a generous supply of condoms in the drawer of the nightstand. I think we won’t need to buy any more, and that is a pleasant thought.

Oh how we laughed! It’s been nearly a year since this was written, and SilverHubby remains unsterilised. In part 3, we’ll go into what went wrong.

Our Contraception Part 1: Why is Contraception so Hard?