Definition:

Vas deferens = A coiled tube that carries sperm out of the testes, and into the urethra.  [REF]

Deconstruction:

The well-known birth control method “vasectomy” stems directly from this similarly-spelled feature of the male anatomy.  Not surprisingly, this medical procedure is focused specifically on the masculine seed source in the body’s reproductive system.   

As is the case with most medical lingo, the root word “vas” is of Latin origin, referring to any internal conduit for conveying bodily fluids; the medium and mode of transport being quite clear in this case.

In contrast, “deferens” is much harder to trace from a literary standpoint.  Some researchers suggest this second term references a descriptor for “downward-facing”, as the usage was originally recorded in 1578, during the latter half of the Renaissance period, when substantial discoveries were being made with regards to animal and human physical components. 

“-ectomy” is now essentially part of modern American lexicon, considering the proliferation of medical shows on television, and surgical details searchable over the internet.  Pretty much any internal organs can now be “surgically removed” through novel technological advances, as this suffix describes, from the useless appendix to the important uterus. 

Amusingly, looking at English word usage, references to vasectomies peaked just before 1980, coinciding with increased awareness and education regarding birth control methods and family planning techniques, following the free-love “Hippy” era which personified the prior decade.

Since the turn of the millennium, online conversation of this reproduction restriction method has flatlined, maintaining some societal relevance, while not spiking within the public discord.

Enough nerdy English class content.  It’s time to move on the meat of the material, which is much more likely to be learned in Biology or Home Economics lectures.

Mating, pregnancy, birth, and parenthood have all manner of stereotypical preconceived notions based on sexuality, a few of which are summarized in the bulleted list to follow.

• Girls and boys hit puberty at different times; there are unique complexities with each sex’s reproductive system.

• Condoms are confusing, with internal and external versions, not to mention different sizes, textures, materials, colors, and even flavors.

• 9 seconds versus 9 months is a vastly divergent level of human commitment for an activity which can take just moments to consummate.

• Why are birth control and reproductive health obligations deferred to females, when both engaged parties have an equal role to play in the result?

• Breadwinner versus caretaker: this traditional breakdown of marriage roles has been in place across civilizations for millennia.

The logical next step in this chain of reasoning is exploring the cost of contraception.  Not surprisingly, based on historical gender norms, various inequities have developed over time. 

On a broad level, health care costs understandably vary by sex and race, based on actuarial projections.  On average, women have a longer life expectancy then men, and incur more medical expenses over their lifetime, primarily due to their increased longevity, along with hospital care needs related to childbirth.

However, in the reproductive system realm, relevant drug and insurance policies aren’t as clear cut.  Also, while bodily autonomy and self-control has been instilled within developed nations, sexual relations across many other parts of the globe are much less refined.

Below is a breakdown of the technique, frequency, cost and effectiveness for common contraception alternatives.  [REF]

• Condom (Single Use) = $2 Each [Need Based Quantity] – 85% Effective.

• Diaphragm (Annual) = $40 Yearly – 88% Effective.

• Birth Control Pill (Daily) = $50 Per Month – 91% Effective.

• Vaginal Ring/Body Patch (Monthly) = $30 Per Month – 91% Effective.

• Birth Control Shot (Quarterly) = $50 Each Quarter – 94% Effective.

• IUD (5+ Years) = $1,000 Installation – 99% Effective.

• Sterilization (Permanent) = $6,000 Surgery – 99% Effective.

Each contraception decision requires a different level of doctor visits and routine maintenance, all of which can add cost.  There are numerous considerations that should be factored in: insurance plan coverage, available financial resources, side effect influence, current sexual activity, pregnancy planning timeline.

Abstinence and ovulation forecasting are free approaches that can work for some couples, based on their desire to have, and ability to schedule, intercourse sessions.  But there’s a pair strikingly similar medical procedures, available to both males and females, which offer up pregnancy protection without the need for moderation.

Vasectomy  –  Male  [REF]

Time for a deep dive into the vasectomy surgical procedure, which falls decidedly on the long-term, semi-permanent, side of the ledger.  Even if you’re squeamish, read on, as this medical maneuver is about as mundane as it gets.

The entire operation only takes between 10 and 30 minutes to complete.  First, a small needle is injected in the scrotum, to numb surgery area with a local anesthetic.  Once the drugs take hold, the surgeon makes a tiny incision, via scalpel, or minute puncture, using non-invasive techniques, in the upper portion of the scrotum.

Next comes the important part, locating the vas deferens, the tube that transports semen out of the testicles.  The skillful doctor can withdraw the vas deferens vessel through the small hole created, and sever this conduit in half.  To completely ensure lack sperm transport, the ends of the vas deferens are sealed via tying, cauterizing, or clipping, then return inside the scrotum.

With the key steps of the procedure executed, the modified innards are returned to their original location. After closing-up the external skin incision via stitches or glue, the patient is as good as new.

This wound heals up naturally in 48 hours, though some swelling and bruising may be experienced shortly after the operation.  Ice packs and tight-fitting underwear can be used to minimize the pain during the recovery process.  Any physical activity should be avoided for the first few days, with a one-week break from sports and heavy exertion required. 

The vasectomy process is a safer surgical procedure, and less prone to complication, than the tubal ligation approach description to follow.  “Getting snipped” is non-invasive and essentially painless.  The entire operation takes only 15 minutes, and can be executed by any qualified urologist.  Full recover only takes a couple days, then you’re back on the horse, so to speak.

While getting a vasectomy is a very straightforward process, there are a few downstream elements to consider.

Patients are encouraged to avoid sexual activity for a week as well, and if the mood strikes, should use alternate means of birth control during this timeframe.  It takes roughly 20 ejaculations to work through the sperm still in one’s tubes; after that point the individual will only release seminal fluid.  From then on, the released sperm is absorbed by the body, which is harmless.

A follow-up visit with the selected doctor or a licensed urologist to confirm no sperm is present in the semen typically occurs 6 to 12 weeks after the initial operation.  Most failures of this simple surgical approach to prevent pregnancy occur during this transition period.

Aside from potential blood clots and incision site infection, major side effects are rare.  Other misconceptions about the impact of a vasectomy have also been thoroughly debunked over time: pain during surgery, hindering sexual performance, permanent organ damage, and increased cancer risk.

A vasectomy simply stops the reproductive system from releasing sperm.  Testosterone is not influenced, nor is libido.

Tubal Ligation  –  Female  [REF]

The human anatomy is often redundant for survival purposes.  In this case, men have two testicles, and women have two ovaries.  As a result, the conduit to both these reservoirs must be closed to prevent procreation.  The vas deferens and fallopian tubes, for males and females respectively. 

Breaking either of these physical reproductive linkages in the human body is over 99% effective in avoiding future pregnancies.

Interestingly, the process for a tubal ligation is very similar to a vasectomy.  The common moniker of “getting your tubes tied” translates directly to the verbiage of this procedure in Latin. 

In this female case, the fallopian tubes are cut, then sealed off, using the same surgical mechanisms as those applied to the vas deferens.  The fallopian tubes connect the ovaries, where eggs are stored, to the uterus, where the ovum gets fertilized by sperm during intercourse.

A tubal ligation is more complex and invasive than a vasectomy.  As a result, this procedure is often done in combination with childbirth, or other scheduled abdominal surgery, though it can be executed as a stand-alone operation. 

This medical action requires an incision in the naval, pubic bone, stomach, or some combination, depending on the techniques used: laparoscopy versus laparotomy.  Recover can take several days, potentially even including an overnight hospital stint.   

One of the main downsides of getting one’s tubes side is the regret about no longer being able to bear children.  That’s why this procedure is not recommended for women under 30 years of age.  Another concern is post-tubal ligation syndrome, which can manifest with a variety of symptoms: back pain, random headaches, period cramping, and abnormal bleeding.

A tubal ligation shouldn’t have any effect on period cadence or experience.  As with sperm generation, ovulation still occurs, with released eggs breaking down and becoming absorbed by the body.  Upon further inspection, it’s impressive how similar the male and female reproductive systems are.

Though requiring internal surgery, this sterilization method represents a natural means of modifying the female reproductive function.  In contrast, most temporary forms of birth control pills, and some IUDs, rely on hormonal elements which can cause unwanted side effect with regards to both mood and health.

Negative short-term side effects of hormonal treatment approaches in women include cramping, depression, headaches, irregular bleeding, mood swings, skin issues, and weight gain.  There’s also an increase in long-term issues with hormonal birth control: blood clots, cancer risk, heart attack, and stroke.

An exploration of birth control techniques wouldn’t be complete without analyzing the effectiveness of each option.

From an efficacy standpoint, it’s hard to argue against these in-body operations. Vasectomies are incredibly reliable, registering a 99.85% pregnancy protection rate.  Similarly efficacious are the surgical options available to women, an intrauterine device, or IUD, and tubal ligation, i.e., getting one’s tubes tied.

In comparison, standard birth control methods have much higher failure rates over an annual basis, assuming a once-weekly intercourse cadence: pill = 9%, condoms = 18%, withdrawal = 22%, nothing = 85%.  Obviously, there are numerous other factors that influence the likelihood of pregnancy, like circumstance, fertility, health, stress, and menstrual rhythms.

In summary, a vasectomy procedure incurs a one-time cost of roughly $1.5k.  In contrast, tubal ligation is 4 times more expensive, at approximately $6k total.  However, often insurance companies are more generous with regards to reimbursement for female operations, especially if they can be connect with an existing hospital visit.   

Vasectomies are essentially permanent, so it’s important to have profound conversations about family planning goals before electing to get this surgical procedure.  In vitro fertilization and adoption are still viable options after a vasectomy, but represent much more expensive paths to having a child than natural conception and childbirth.

Per numerous medical studies, vasectomies don’t affect sex drive, or mandate any extra effort when the moment strikes.  Even better, there’s no need to thrash around opening a spermicide ladened condom, or worry about missing a daily pill dose of hormones.

It’s important to remember that both vasectomies and tubal ligation procedures don’t protect against spread of sexually transmitted diseases.  As a result, reliance on such methods makes the most sense in a clean monotonous relationship, as opposed to an individual who’s still mating out in the wild.

Also, vasectomies are typically reversable, while tubal ligation is essentially permanent.  Thus, the male procedural choice allows for more natural offspring options in the future, especially for young married couples.  However, a vasectomy reversal can be expensive, and is not always successful. 

From a family planning standpoint, it’s important to execute short versus long cost benefit analysis of the various birth control options.  What’s cheapest in the near term may not be the best financial decision over an entire lifetime.

On a depressing yet relevant front, over 90% of rape victims are females; the emotional damage endured is harsh enough without having to worry about ending up with an unwanted pregnancy.  Equally skewed, less that 5% of individuals who pay alimony for a child are women.  These disparities are hard to ignore when it comes to equitable procreation in the real world. 

A final consideration is that having body control and autonomy is important, especially for young females who are still trying to find their perfect mate.  Also, women are more prone to take care of their bodies, and pretty much anything else, than men.

There’s a much broader ancillary discussion to be had on this reproduction topic regarding global birth rates. 

In affluent developed countries, lower sperm counts in men, caused by increased exposure to petrochemicals, and reduced fertility windows in women, based on work aspirations leading to later family formation, has resulted in a measurable reduction in procreation.

Conversely, within the emerging world, most notably throughout the African continent, birth rates per female remain quite high, well above the generally accepted 2.1 offspring replacement level.  In these population growth regions, ancillary issues with procreation like transmission of STDs and garnering sufficient resources for each baby born are the main issues; problems which can’t be simply solved via vasectomies.

Later in the 21st century, there’s a viable scenario where snip-snips should be free for all young guys, and potentially even mandated.   While seemingly dystopian, this procedure is fairly reversible, in case folks change their mind as they age and mature.  One downside of this plan is that it may result in more unprotected sex and less commitment of men in relationships, an issue that already plagues many unplanned family units.

In contrast, there’s an equally viable future situation where, considering the modern era of dropping birth rates and fertility levels, maybe offspring creation and rearing should be encouraged rather than hindered.  In this case, the hope is that medical advances can be leveraged to facilitate family formation, be it via love, loot, or labs.  This seems like another private realm where meddling governments could inadvertently intervene.

As Michael Crichton’s Jurassic Park novel highlighted, messing with biology’s natural proliferation methods can have substantial adverse consequences.  Thus, any future human reproductive system modification policies must be enacted with care and tact.

There’s a vast difference between the population boom and bust scenarios, with maintaining the status quo of current societal stability falling squarely in the middle.  Only time will tell how the path of procreation plays out.

Details:

• Vas deferens etymology, which is sparse.  [REF]

• Lengthy research paper on the history of the vasectomy procedure, for medical nerds.  [REF]

• Cleveland Clinic anatomical description of the vas deferens.  [REF]

• Bulleted list highlighting effectiveness and benefits of a vasectomy.  [REF]

• Long-term analysis of women’s contraception options, with a biased tilt towards sterilization.  [REF]