From Sterilization to New Life: Vasectomy, Regret, and Reversal

In March 2014, at the age of 34, I went to my local healthcare center and had a vasectomy. To this day, my wife and I cannot easily explain why we decided to have the procedure. We had recently completed the “full set”—a boy and a girl. We were tired from chasing two toddlers around the house. We were financially stressed. I had internalized the notion that a small family was a responsible decision. And we believed we were finished having children. My wife hated being on the pill, so a vasectomy seemed like the best way to proceed. 

At the same time, vasectomies had become normalized within our community. The men in our church would talk about it jokingly. In fact, many of our friends timed their vasectomies with March Madness—figuring, that if they were going to be laid up on the couch, they might as well watch basketball all day. This trend—the March vasectomy spike (along with the end of the year)—has been empirically confirmed. 

About 500,000 men get a vasectomy each year in the United States. By the age of 45, about 18% of American men will have had one. A mix of anecdotal and small sample studies points to a significant increase in vasectomy procedures since Dobbs vs. Jackson with a notable spike in the number of childless men having the procedure. 

For me, the process itself was exceptionally easy. I was able to make an appointment with a urologist within a matter of weeks. He performed a basic physical exam and confirmed that I was certain about the decision. Within two weeks, it was over. Although a vasectomy can be performed in a physician’s office, my surgeon preferred a hospital setting. So, I arrived at the hospital, was put to sleep, and woke up sterile. 

Vasectomies had become normalized within our community, with many men at our church joking about it.

The procedure was entirely covered by health insurance. Male sterilization—including vasectomies—are not required to be covered by insurance under the Affordable Care Act. Yet nearly 90% of all employer-sponsored health insurance plans and all state Medicaid programs do, in fact, cover the procedure. 

Regret

Within the first six months of having the procedure, my wife and I were overcome with the sense that we had done something gravely wrong. She desperately desired more children and regretted the seemingly hasty decision we had made. I often found myself looking over at my rapidly growing children and asking, “I wonder what the next one will be like?” before being struck by the realization that there would be no next one. Beyond the desire for more children, we also sensed that we had done something existentially wrong. I was also bothered by the fact that I had damaged my body—a gift from God—for no reason other than convenience. 

In fact, regret is not unusual when it comes to vasectomies. Vasectomy supporters say “most men are satisfied with their vasectomy”—true enough. Yet nearly 20% of men who have had the procedure desire more children after their vasectomy. Of course, desiring more children is not exactly the same thing as “regret,” but a striking number, nonetheless. 

Our own regret about my vasectomy led to months of agonizing over what to do. We consulted extensively with friends. We poured over the theological arguments around contraception and sterilization. We prayed. In fact, our reading and prayer lead to our conversion to the Catholic Church. We came to the realization that we had broken something very fundamental—the relationship between the spiritual and physical ends of our marital relationship. 

We were assured by faithful Catholic priests that we were under no obligation to reverse the procedure. But ultimately, my wife desperately wanted more children, and I wanted to be made whole again. So, we searched for vasectomy reversal options.

Reversal

I went back to the same urologist and explained that I regretted the decision and wanted to reverse the procedure. The reversal is a bit more complicated than the vasectomy. Still, he assured me that the success rate was quite high. 

Despite the relative ease of the procedure and the success rates, very few men end up having a reversal. Roughly 10% of those who have had a vasectomy return for a consultation to explore surgical options, and around 6% will ultimately have the reversal. The biggest factor that predicts a reversal is remarriage.

Why do some men who change their mind end up having the reversal? There are certainly many reasons, including fears about surgery. Also, a desire to have more children is not exactly an intention to have more children. But certainly, insurance coverage is relevant. In contrast to the vasectomy procedure, which is considered medically necessary by most providers, there is almost no insurance coverage for vasectomy reversals. In my case, while the vasectomy was covered under my insurance, the reversal was not. My surgeon told me that the reversal would likely cost around $15,000.

Sometimes, I get hit with a wave of sorrow when I see the empty seats around the table and imagine the other children who might have been born during the decade after my vasectomy.

My wife and I wanted more children, but $15,000 is a lot of money. So, we looked for other options. We settled on a physician with great reviews and low cost. In November 2021, my vasectomy was reversed. The procedure was simple and relatively painless. During the ride home from the procedure with my family, the realization of what I had done really hit me: our family was open to life once more!

New Life

Still, we wondered if my wife would we ever get pregnant again. There are essentially two factors that determine pregnancy after a successful reversal—years since vasectomy and maternal age. Neither were working in our favor. It had been nearly 10 years since I had the procedure, and my wife was over 40 years old.

We spent three years praying that we would have another child—with no results. It all felt a bit grim as the odds were against us. But three months after our 20th anniversary, my wife came home from work and announced that she was pregnant. And 13 years after our last child and 10 years after my vasectomy, we welcomed a baby girl! 

I often find myself looking around the dinner table with great joy at my three children. It is hard to describe how grateful I am for our newest baby—StellaMaris. Sometimes, though, when I least expect it, I get hit with a wave of sorrow. I see the empty seats and imagine the other children who might have been born during that decade after my vasectomy, had we chosen differently. I realize that my wife and I made the decision to have the vasectomy on our own, but I also wish that in that time of great vulnerability, there had been a bit more resistance—nudging us toward openness to life. Perhaps, if we had been charged $15,000 for the vasectomy itself, we might have said “No thanks.”

Grant Martsolf is a Nonresident Senior Fellow at the Institute for Family Studies, and a Professor at the University of Pittsburgh. He previously worked as a Health Policy Researcher at the RAND Corporation in Pittsburgh, Pennsylvania.

Editor's Note: The opinions expressed in this article are those of the author and do not necessarily represent the views, policies, or positions of the Institute for Family Studies.

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