Cutting supply for effective birth control

A vasectomy is more reliable than female sterilisation as a method of contraception

A vasectomy is more reliable than female sterilisation as a method of contraception

SHORTLY AFTER Dr Andrew Rynne performed Ireland's first vasectomy in 1974, he received a visit from his local Catholic priest who tried to dissuade him from carrying out further vasectomy operations.

After all, this wasn't too long after members of the Irish Women's Liberation Movement travelled to Belfast on what became known as 'the contraceptive train'. The women bought condoms and other contraceptives in Belfast and returned with their illegal imports to challenge the customs officials at the Dublin terminus. Much like contraceptives, vasectomies were seen as an immoral form of birth control.

"That was the backdrop to it," says Rynne. "You just ignored it and kept going. Vasectomy was never illegal in Ireland. It was always legal."

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Whatever the priest said to Rynne obviously didn't have the desired effect. Over the past 30 years he has carried out some 25,000 such operations.

Rynne reckons that around 1,000 vasectomy operations - commonly referred to as 'the snip' - are carried out in Ireland each year.

Drogheda-based GP Dr Oliver Lynn says that a vasectomy is becoming an increasingly popular method of birth control for men.

"There is an increasing awareness of it as men become more educated and more involved in family life. They are much more receptive and it has gained a lot in popularity over the past 10 years," he says.

The procedure is quite simple and is usually carried out under local anaesthetic, according to Rynne.

The tubes that carry the sperm up from the testicles (vas deferens) to where they are mixed to form the semen are cut or blocked. This prevents the sperm from joining the semen at ejaculation. If these tubes are cut or blocked, the sperm cannot get outside the body and is reabsorbed within the testis and the epididymus. Seminal fluid will continue to be ejaculated when a man reaches a climax but it will not contain sperm, thus preventing conception.

On average, the procedure takes about seven minutes to complete and once you have received the local anaesthetic you will feel nothing at all, says Rynne. Receiving the local is quite uncomfortable but it only lasts for a few seconds, after which the patient feels nothing whatsoever.

"The first 24 hours immediately after vasectomy are what's important," he says. "These should be spent resting quietly on a settee watching TV or reading and not walking around."

Lynn says the procedure is minimally invasive and is less disruptive than many operations.

"I perform operations on guys on a Thursday or Friday and they're back to work on Monday," he says.

There are potential side effects like any operation but they are very rare. They may include infection or bleeding but they are treatable. Nor does it impact on men's sex lives.

"There's no change in sensation. It doesn't make intercourse any better or worse," says Lynn.

Some stray sperm may still be in the semen and it usually takes 10 to 20 ejaculations to completely clear sperm from the semen. Couples are still advised to use contraception until two tests are carried out 16 and 18 weeks after the operation to ensure there is no sperm present.

That makes vasectomy a very effective contraceptive, says Lynn.

"It is over three times more reliable than female sterilisation as a method of contraception and one of the reasons is because we can get the semen checked," he says.

Given the fact that it is highly effective, having it done is a very personal decision for any man to make, says Rynne. Because it is regarded as a permanent method of birth control, the decision to go ahead shouldn't be made lightly and those opting for it should be very sure about their decision.

"The decision is the most important aspect to it," he says. "A man shouldn't be coerced into it. You know by the body language almost when a man comes in that he's okay about it."

Some clinics offer counselling to men and couples considering the operation.

"Some clinics take a very conservative view and insist the couple sit down and be counselled," says Rynne. "I think that is excessive to be honest. We are all mature adults who make decisions for ourselves."

Vasectomies are more reversible today than many years ago, according to Rynne. With new IVF technology, sperm weakened by antibodies can be treated, he says, adding that in this way about 75 per cent of all vasectomies can be successfully reversed so as a pregnancy ensues.

"That's a road we don't like to go down when we are talking about vasectomies because if you have ideas about fathering children you shouldn't be getting it done in the first place," he says.

Lynn agrees: "A man has to go into it in the understanding that it's for keeps."