When Matthew Rota got a vasectomy at 21, he had already been trying unsuccessfully to have the procedure for three years.
“Initially I attempted to do it when I was 18 years old, but I obviously got turned down,” Matthew told Insight.
“They said, ‘Come back when you’re 25,’ but after looking on Reddit it seemed that the general pattern was that you consistently get told every time you go back, to come back when you’re [older].”
Even though the legal age in Australia to get a vasectomy is 18, “historically the profession has been reluctant to operate on people under 30,” according to Dr Justin Low, one of Australia’s leading vasectomy doctors.
This is because there are that show a high rate of regret and reversal in this age group, up to 12.5 times higher than those over 30.
Between 2020 and 2021, “there’s been close to a 20 per cent increase in the number of childless men under 30 requesting vasectomies…it’s getting to the point where once or twice a year we have a list where half the men getting vasectomies are childless,” Dr Low said.
This rise in young men seeking a vasectomy can be attributed to several reasons.
A recurrent theme amongst Dr Low’s patients is what he refers to as “a reverse biological urge.” These men are challenging the long-standing social pressure for “everyone to want kids at some stage.” There are more young men realising they have no desire to be fathers and are taking inspired action.
Other reasons include young men’s concerns about the planet and the repercussions of overpopulation.
“I felt like there was a significant chance that I might introduce a new person who would contribute to deforestation, to animal suffering and who would suffer themselves,” Matthew said.
Although he did consider using contraception, he came to the conclusion that it wasn’t foolproof.
"I wanted to guarantee as much as possible that I wasn’t going to accidentally create new life when I didn’t intentionally want to do so.”
Dr Low said one way of ensuring that patients are making the right decision is to seek an independent psychological consultation. A counselling service was implemented in 2018 at , the clinic at which he performs the procedure.
Matthew pictured with his girlfriend.
Five years on, Matthew is no longer single.
“Now I’m living with this woman, someone who I know I want to truly spend the rest of my life with and we want to essentially start a family.”
He is confident there are options available for him to become a father.
“We’re looking at reverse vasectomy because it’s a lot less complex in terms of the money required and length of time, compared to IVF,” he said.
While it is possible to reverse a vasectomy, Dr Low said there’s no guarantee it will work.
"Rates of success decline as you get further away from the vasectomy date."
It’s difficult thinking about the fact that the reverse vasectomy might not work.
Dr Low cites a which shows men who had their vasectomy reversed after three years have a 76 per cent chance of their partner falling pregnant. That rate falls steeply for men reversing their procedure after 15 years or more, to just 30 per cent.
Male fertility expert, professor Robert McLachlan believes five to 10 years following a vasectomy gives men a reasonable prospect of a successful reversal.
But according to professor McLachlan, a vasectomy doesn’t reduce overall male fertility, which means that even if a reversal is unsuccessful, the quality of sperm retrieved directly from the testes is as good as if the vasectomy had not taken place.
He acknowledged however that the rate of pregnancy is lower because the success of IVF depends on a number of factors including the female partner’s age, health and quality of eggs.
Dr Low advised young men to use a sperm bank before the vasectomy “as an insurance policy” if they change their mind. He believes this is a more cost-effective strategy than sperm retrieval from the testes post-vasectomy.
For Matthew’s partner Christina, “it’s difficult thinking about the fact that the reverse vasectomy might not work.”
“It makes me very emotional to consider that as a real possibility. But I think it’s just meaningful knowing that we did everything we could,” she said.
Hear more from these, and other guests, on Insight’s episode,
