As a reversal specialist, I commonly see both men and women who regret their sterilization procedures. Sterilization regret seems like an obvious concept but it is actually very hard to define, study, and discuss.
Regret is difficult to discuss with patients before a vasectomy or tubal ligation because most patients don’t think they will ever regret their procedure.
Who gets married with plans to get divorced… who has a child and plans on their child’s untimely death?
Most patients will not regret their sterilization procedure; however, a significant number of them will at some point in their life. Regret can often be normal and healthy but it can also be abnormal, persistent, and life changing.
The key to understanding the unique risk of sterilization regret starts with an acknowledgement that none of us can predict the future.
Regret: Not the most immediate risk
Although sterilization regret is not the most immediate risk of sterilization, it is the most common.
Large studies of female sterilization have demonstrated less than 4% of women will regret their sterilization in the first several years. With the passage of time, these same studies have demonstrated the percentage of women who regret their sterilization procedures will increase and as many as 30% will regret their tubal ligations.
It is estimated that up to 20% of men may regret their vasectomy procedures. Regret changes with time.
Regret can be transient and normal and regret can also be persistent and abnormal.
Normal regret: Common and transient
Normal sterilization regret is when a person occasionally wishes they had the opportunity to have another child. They may transiently regret their sterilization and may even briefly consider reversal. These thoughts and desires are common, normal, and should be expected.
Often the person will realize they made their decision for very real and personal reasons, these reasons still exists, and they will then remind themselves why they made their decision in the first place. Often the intellectual aspect of their decision making will overcome any emotional feelings they have about their previous decision.
It is normal to regret decisions. Regretting something does not always mean you made the wrong choice.
Abnormal regret: Emotional, intrusive, and persistent
Abnormal regret is often strong, persistent and intrudes into ones' daily life. There is often a strong emotional component to this regret and the emotional feelings will often predominate over the intellectual decision making.
Abnormal sterilization regret often seems to be cultivated by unforeseen and serious life changes: divorce, death, abuse, previous emotional and physical neglect, religious experiences, persistent side-effects from their sterilization procedure etc. Occasionally there is no such life change and a person may simply regret their decision without any real reason.
Abnormal regret is when one thinks of their sterilization with frequency, regrets the reasons that contributed to their decision, wishes they had not done it, and seriously considers having sterilization reversal.
Vasectomy regret risk factors
Risk factors for vasectomy regret have been identified. The following are conditions that increase the chance of vasectomy regret:
- Having a vasectomy while in an unstable marriage
- Having a vasectomy younger than 31 years of age
- Having a vasectomy without having fathered a child
- Having a vasectomy when your children are very young
- Having a vasectomy during or because of a financial crisis
- Having a vasectomy as a response to a recent pregnancy
- Vasectomy has caused an adverse health effect
- Perceiving your vasectomy as having caused an adverse health effect
Although most men will not regret their vasectomy, regret can be a common long-term risk of the procedure for some. Although regret will have little impact upon your physical health, extreme regret can influence your emotions and interpersonal relationships.
Treatment for vasectomy regret
Having a child after a vasectomy will require either adoption, in-vitro fertilization (IVF) or vasectomy reversal.
IVF is approximately $14,000 for each attempt and will require sperm be recovered from the epididymis with needle aspiration. This is a painful procedure and adds more cost to each IVF cycle.
Vasectomy reversal can be an option for many who suffer vasectomy regret. Vasectomy reversal is costly, is not covered by health insurance, but can be up to 90% successful at restoration of sperm. The success of the vasectomy reversal decreases with the length of time since having the vasectomy procedure.
Although vasectomy reversal can be highly effective it is not always guaranteed to be successful or result in pregnancy.