Why more men are choosing a vasectomy earlier in life

Alex West decided to have a vasectomy in his late 20s after difficult experiences surrounding the births of his two sons left him questioning whether he could cope with having more children.

The Kent mortgage broker had originally hoped to have four children with his wife. But the trauma of her first labour, followed by his own postnatal depression, changed his view.

When their second child was born, the delivery went more smoothly for his wife. Alex, however, suffered a panic attack and broke down.

“I had a panic attack and broke down. I hadn’t been able to – I didn’t have the ability to – process that,” he says.

He remembers the months after the births of his sons as “grey”, saying life felt devoid of colour while people around him repeatedly told him fatherhood must be a wonderful experience.

“I didn’t feel this love and connection that everybody says I should have,” Alex says.

The couple eventually agreed to stop having children after two. Because Alex had been the main driving force behind that decision, he felt it would be unfair to expect his wife to take responsibility for contraception.

So, in May 2024, aged 33, he travelled by train with his wife from their home in Kent to a clinic in London to have a vasectomy.

The operation involves cutting and then clamping or sealing the vas deferens, the tubes which carry sperm from the testicles to the urethra. It is often referred to as “the snip”.

“I put my headphones on and I listened to about three songs before they said it was all done.

“Ridiculous – crazy quick.”

More men having the procedure

A total of 26,385 vasectomies were carried out in hospitals and clinics in England during 2024-25, according to NHS England figures. That was a 16% increase on the previous year.

Men aged 35 to 39 accounted for the largest number of procedures, with about 8,400 vasectomies recorded in that age group.

There was also a small increase among younger men. About 950 procedures were performed on men aged under 30 in England in 2024-25.

Alex had first decided to pursue the operation in his late 20s, but his NHS doctor advised him to wait until he was 30 in case he later changed his mind.

The procedure is considered permanent, because reversal is only possible in some circumstances and is not always successful.

Sam Knight, who is from the United States, was 22 when he sought a vasectomy after deciding he did not want to become a parent.

He says he had repeatedly found himself in situations where having children might become a possibility, and that prospect began to worry him.

When his then-partner became pregnant, she chose to have an abortion. Sam said the experience made him determined to prevent a similar situation happening again.

“[I had] a realisation of this thing that I’ve put somebody through and I just didn’t want that to ever happen again.”

He contacted a urology clinic in New York and was required to explain why he wanted the operation. His doctor stressed that he should regard the decision as permanent.

Because Sam was so young, he had prepared for questions including whether he might change his mind, whether he was too young to know he did not want children and whether he understood that reversals could be expensive and unsuccessful.

“[The doctor] actually said he had very recently changed his view,” says Sam. “And that, if I had come in half a year earlier, he would have turned me away instantly.”

His vasectomy was performed a couple of months after he first contacted the clinic.

Guidance from NHS Scotland says men under 30 are more likely to regret having a vasectomy, which is why doctors may take particular care to establish that a patient understands the decision.

Dr Sarah Salkeld, a former GP and now medical director at MSI Reproductive Choices, says vasectomy is “very safe and effective”. However, she advises men to “really think about” whether it is appropriate for them.

“We offer everyone counselling to talk about it if they want to, just to… make sure they’ve got all the information they need to make that decision.”

Reversal procedures are not routinely available on the NHS, she says, because strict criteria apply.

The NHS says men can also consider other forms of contraception, including condoms and the fertility awareness method. That involves avoiding sex or using condoms on the days when a female partner is most fertile.

A decision about parenthood

Sam says he loves children and had a happy childhood, but wanted to concentrate on his work as a sound designer for video games.

“I’ve devoted my life to this and, to me, parenting is something you also devote your life to,” Sam says. “I just don’t have the mental space or the time to do that, or even the desire to.”

Now 25, he says he envies people who want to become parents because the experience “clearly has” beauty and love in it. For him, similar fulfilment comes through music, art and his career.

The procedure and aftercare cost about $1,200 (£849) in total. At the time, Sam was still covered by his family’s health insurance policy.

According to the National Survey of Family Growth, which analysed responses from about 4,000 men in 2022-23, fewer than 1% of men aged 18 to 29 in the US had ever had a vasectomy. Men in their mid to late 40s were the most likely age group to have had one, with 15% saying they had undergone the procedure.

Sam experienced one episode of severe pain about a week after his operation. Dr Salkeld says that is a recognised but uncommon side effect of vasectomy. The pain eased after several hours.

He does not believe the experience should discourage other men.

“Overall, it is worth the money and it is worth the pain,” he says.

Another man told us that the sacrifices and uncertainties associated with parenthood, including concerns about how his children might turn out, contributed to his decision to have a vasectomy at 27.

For Alex, the operation felt like the fairest and most effective contraceptive option for him and his wife. They considered it for several months, knowing he did not want to expand their family.

“I absolutely adore my children,” Alex says, particularly now that they are old enough to play football with.

“If I had added more to the team, it wouldn’t have been the right thing for me.”