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Vasectomy is NOT 100% effective. Why aren't couples adequately taught that is the case? #1132/9

First let me thank you for taking time out of your busy schedule to talk to me this morning.  Per your request, here are some of the social consequences I have faced as a result of getting pregnant and giving birth to my husband’s child, conceived after his vasectomy failed.  Incidentally, before I go into those, here is a rehash of his lab results which I have in hand:  The lab results state that on 5/2/01 (vasectomy was performed on 12/15/00) that: sperm seen-none seen; wbc seen 0-2, rbc seen 0-2.  On October 22, 2002 his semen analysis was: volume 4.5 mls, count 9 million/ml, motility 90% forward progressive motion, morphology was 85% normal.

 

In contacting various urologists my understanding is motile density is the most important factor in the ability to father and that is 8.0/ml and above.  My husband, doing his math, has a motile density of 8.1/ml and four urologists confirmed that since motile density is what constitutes a normal result for anyone, he had a normal result.  Also an urologist examined his and says, “I feel that the right vas deferens is in continuity” – diagnosis recanalization of the vas after the vasectomy. 

           

That said, I have personally faced a number of social consequences as a result of my husband’s failed vasectomy.  My pregnancy was discovered very late.  I had gone off the pill after my husband had his vasectomy and ceased paying attention to when my periods were, having been led to believe that a vasectomy failure was such a minute possibility that I didn’t need to worry about it.  As a result, I found out in my mid-30’s when I was 27 weeks along that I was pregnant. 

 

I did drink socially during the first 27 weeks, a glass of wine occasionally with dinner, which lead doctors to fear fetal alcohol syndrome might occur.  I felt an immense amount of guilt over this and I put my son’s well being in jeopardy as a result of the late discovery.

           

We opted for adoption since neither my husband nor I had ever wanted children.  After our son was born in September, 2002, perfectly healthy incidentally, I changed my mind about parenthood but my husband did not.  This led to my being forced to choose between single parenthood or adoption.  I chose adoption but our marriage nearly resulted in a divorce after our son’s birth and it has taken a year and a half to put it back together.   

 

 

The adoption agency admitted when our son was five months old that they had always assumed that I was lying about the failed vasectomy and was passing our son off as my husband’s to cover up an affair.  They were surprised to find I was not lying after I gave them my husband’s semen analysis numbers from one month after our son’s birth.  Since I had NOT cheated I was very deeply offended.

           

When I went into therapy right after our son was born the first thing the therapist did was said he had to know, had I cheated on my husband.  Again, since I had not, I was very deeply offended.

           

I am a government contractor and have a secret clearance.  I periodically go through reinvestigations to renew my clearance.  I was told that I had to list my son and list all of the circumstances of his birth, the vasectomy failure and all of the details, so that they could make sure there was nothing I could be blackmailed over.  I did do all of this but I feel certain that had it been any other form of birth control that failed I would not have faced such questions.

 

A year after trying to conceive our second child, three urologists, after having looked at my husband’s 10/22/02 results, said my husband had no fertility concerns, I requested a fertility workup.  My workup was denied by our HMO stating my husband had had a vasectomy so I wasn’t eligible.  I appealed the decision and won but it involved going before a committee of 15 + strangers, bring in all of my husband’s medical paperwork (he is also a member of the same HMO, by the way, so they had always had access to this information), and I had to offer to do a DNA test on my son to prove paternity, before the HMO granted my appeal.  Incidentally, the written materials provided to us when we had our vasectomy done, clearly stated that a vasectomy was not 100% effective.

 

In summary, my experience as a woman who conceived a child as a result of a failed vasectomy is that I have had to face questions of my fidelity over and over again, and offer proof over and over again, that I have been faithful to my husband.  I truly believe that had any female from of birth control failed I would not have faced these rather devastating social consequences.  I do not believe that I am alone for I know personally of many other stories similar to mind where the woman’s fidelity comes into question when the vasectomy has legitimately failed.

           

Lest I sound like sour grapes, I do love our son dearly, and looking at him now makes everything all worthwhile.  I am looking forward to my infertility consult and determining why I can’t conceive right now, and I look forward to one day holding our next son or daughter, this time PLANNED.  When that moment happens all that I have faced will be worthwhile.  More than anything, I hope that in sharing my story I may help some other woman avoid some of the social consequences I have faced, as they are devastating.

 

If there are any other questions I can answer, please don’t hesitate to ask.  I will use some of the information you gave me in my book about my whole experience.


Your case demonstrates that pregnancy can occur after a vasectomy – even after a negative post – vasectomy semen analysis showing no sperm.  Clearly recanalization of your husband’s vas deferens occurred a year to two years after his vasectomy.  We should more actively encourage periodic repeat semen analysis following vasectomy (not only in the months immediately after vasectomy but also 2 to 3 years after vasectomy).

 

The consequences of a failure of vasectomy can be immense.    I am glad that there is a “silver lining” in your case.

 

Summary:    Vasectomy is not 100% effective.  Repeat semen analysis can detect late recanalization of the vas deferens.  Yours is one of the most interesting sterilization cases I have ever reviewed.  It seems to have worked out well for you.

 

 



These diagrams may be reproduced without permission provided the material is distributed free of charge and the publisher is acknowledged (EngenderHealth).

 

 

Key Words:  vasectomy, semen analysis, effectiveness, sperm, pregnancy


Posted 11-27-2009, Updated 12-11-2009, Updated 12-21-2009

Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA
---2009-12-22


Managing Contraception for Your Pocket 2013-2014
  


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