Couples worksheet · permanent contraception

Choosing between vasectomy and tubal ligation, as a couple

Both operations are permanent and both are highly effective. The decision is usually about who has the procedure, how invasive it is and what recovery looks like for your household. This worksheet lays those points out so you can fill in your own answers next to them.

First, are you both sure?

MedlinePlus says vasectomy may be recommended for men who are sure they do not want to get a woman pregnant in the future, and tubal ligation for adult women who are sure they do not want to become pregnant. Reversal of either is possible in some cases but complex and not guaranteed, as the vasectomy vs tubal ligation comparison puts it. If either of you hesitates, a long-acting reversible method may be the better step for now.

Side by side

Setting and anaesthesia from MedlinePlus; times and cost direction from Vasectomy Cost Guide
	Vasectomy	Tubal ligation
Where	Usually in the surgeon's office	Hospital or outpatient surgery facility
Anaesthesia	Usually local; you are awake	May be general anaesthesia
Procedure time	About 15 to 30 minutes	About 30 to 45 minutes
Back to desk work	About 2 to 3 days	About a week
When it counts as effective	Only after a semen test shows no sperm	MedlinePlus: after surgery she can no longer get pregnant
Cost	Lower	Higher

The step people forget with vasectomy

A vasectomy is not effective on the day. MedlinePlus says semen is tested in the months after the operation and the vasectomy is only considered successful once the test shows no sperm; until then, keep using other contraception. It also notes most men return to work within 2 to 3 days and to normal physical activity in 3 to 7 days, wearing a scrotal support for 3 to 4 days.

Scalpel or no-scalpel?

MedlinePlus describes the no-scalpel technique as using a sharp instrument to pierce the skin and make a single opening instead of small incisions. The no-scalpel vasectomy guide notes that the American Urological Association treats both techniques as acceptable and does not rank one as more effective, and that no-scalpel typically means less bleeding and bruising and usually no stitches.

Recovery at home: what is normal

Swelling that peaks around day two and then improves.
Bruising that can look worse on day two or three and fades over one to two weeks.
A dull ache for several days; sharp or worsening pain is not normal.
A little blood-stained spotting for a day or two.

Warning signs that need a call to the clinic are listed in vasectomy side effects and warning signs.

Questions to settle together

Who can most easily take the recovery time off work and childcare?
Which option does each of our insurance plans cover, and at what share?
Do we have a backup method arranged until a vasectomy is confirmed?
Are we both comfortable that this is permanent?

Sources used on this page

MedlinePlus: Vasectomy — setting, recovery, semen testing, no-scalpel technique
MedlinePlus: Tubal ligation — setting, anaesthesia, who it is for