Vasectomy demographics and postvasectomy desire for future children results from a contemporary national survey

Capsule:
Various demographic factors were identified to influence vasectomy prevalence (6.6%), and 19.6% of vasectomized men desired future children, revealing a need for additional counseling on permanent contraceptive methods.

Authors:
Vidit Sharma, B.A., Brian V. Le, M.D., Kunj R. Sheth, M.D., Sherwin Zargaroff, M.D., James H. Dupree, M.D., Robert E. Brannigan, M.D.

Volume 99, Issue 7, Pages 1880-1885, June 2013

Abstract:

Objective:
To describe the longitudinal demographics and family planning attitudes of vasectomized men using the National Survey for Family Growth (NSFG).

Design:
Retrospective cohort analysis of the NSFG using descriptive statistics, national projections, and multivariable regressions.

Setting:
In-home survey.

Patients:
NSFG sampled 10,403 men aged 15-45 on family planning attitudes from 2006-2010.

Interventions:
None.

Main Outcome Measures:
Vasectomy and desire for children.

Results:
There were an estimated 3,646,339 (6.6%) vasectomized men aged 18-45 in the US. Upon multivariable regression the following factors increased the odds of having a vasectomy: currently married (Odds Ratio, OR, 5.011), non-immigrant status (OR 4.405), being an adoptive parent (OR 2.774), Caucasian (OR 2.380), atheistic (OR 2.123), graduate education (OR 1.441), and increased age (OR 1.096). The odds of having a vasectomy directly correlated with the number of children. Surprisingly, an estimated 714,682 (19.6%) vasectomized men in the US desire future children. The only significant risk factor for post-vasectomy regret was frequent attendance at religious gatherings (OR=16.6). 71,886 (2.0%) of vasectomized men reported having a vasectomy reversal.

Conclusions:
This study highlights the importance of preoperative counseling for permanency of vasectomy and reveals an opportunity to counsel couples about vasectomy vs. tubal ligation.

  • Michael Eisenberg

    While excellent, the study highlights the limitations of the NSFG with regards to men’s reproductive health. Given the ages of recruited participants (15-45), many men who have a vasectomy reversal are not captured in the data set. This likely explains the lower than expected rate of vasectomy reversal reported.

  • jim hotaling

    I was surprised to see that such a high percentage of men desire reversal of their vasectomy and also surprised to see that 2% of men had a reversal. While previous work has placed the numbers of men desiring reversal at 5%, this work places it at quadruple that number. I would agree with the authors that this may represent an unrealized opportunity for more reversals or fewer vasectomies, depending on how you look at the data. Regardless, this work is a great use of existing public databases and also highlights how much we don’t know about male reproduction from an epidemiological perspective. I wonder how the authors think the urologic community should address the 18% of men who may want a reversal in the context of the current urologic workforce shortage.

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