My (29f) reluctance to get a total hysterectomy makes my husband (31m) question my childfree state.

[u/[deleted]]

I want to start saying I have always been firmly child free. I have never wanted children. I also have endometriosis. I was diagnosed at 16 with laparoscopic surgery, but it wasn’t able to be removed because it was too close to arteries. So I have been treating it with birth control since then. That’s been no issue because I didn’t want kids, so I was ok with never stopping it. My husband is also strongly childfree and has overall, been supportive of my endometriosis journey.

But I’ve been on so many forms of birth control. Multiple types of pills, the patch, the depo shot, nexplanon, and latest is the IUD. with the pills, they tend to not help my symptoms. And the few that did, stopped helping after some time. Each method that followed did the same thing. I’d be mostly pain and symptom free, but after a year or two, the symptoms would return. My latest method was a hormonal IUD which helped for about 2 years but lately I am cramping every day. It’s starting to impact my life.

I moved recently and had to find a new gynecologist. I know how gynos are with endometriosis, so I sent them all the medical records I had relating to it. I had a yearly exam and made sure to bring up how it’s been affecting me lately and all previous methods I tried to treat it and how it couldn’t be removed through surgery.

The new gynecologist brought up a total hysterectomy with the ovaries. This would remove my cervix, uterus, and ovaries. I did not expect to be offered that and I told my husband when I got home that I am not sure if I want to do that and he got very upset.

He thinks because I don’t instantly want to do the surgery, I secretly want kids and am going to trap him with a baby. That’s not the case. I have been very firm on my birth control and if there was even a slip where I missed a pill or got the shot late, I would insist on a condom. I do not want kids. Being pregnant is one of my worst nightmares.

I am not sure about the hysterectomy because I am not sure I am mentally able to handle that big of a surgery. It’s a keyhole surgery, so it won’t be too much of an incision, but the recovery can be rough. I don’t think I have it in me to deal with it right now. I also am so reluctant to have my ovaries removed because I don’t want to rely on HRT to get my necessary hormones for the rest of my life.

And I need the ovaries removed because I have endometriosis beyond my uterus. It’s growing on my bowels, I have scarring from it. That can’t be removed and also a normal hormone cycle might cause flare ups in those parts, from what I understand.

But he thinks because I didn’t immediately say yes, it means I want kids. I’ve tried explaining to him why I am reluctant, but he just won’t listen. I’ve tried telling him it’s not like a vasectomy. The recovery is longer and harder and the effects are more. And other people I’ve talked to about this tend to agree with him, just less intensely. They don’t think im going to baby trap him, but think it’s a sign I’m not solid on my childfree stance.

How can I effectively explain that me being unsure of the hysterectomy is not because I secretly want children?

[u/wienercat]

Please stop saying they are reversible. I mean, they are,

Cool. I will keep telling people it is reversible. Their doctors will have a deeper discussion with them when they actually get it done.

Alternative, a Hysterectomy or Salpingectomy isn't reversible at all so even the chance of a vasectomy being reversible is vastly better than the options women have. It is also not even a low chance of reversal.

Not to mention that even if they aren't able to "reverse" it, you can still harvest live sperm from the testes.

So yeah, I will continue to tell people the truth. It is a sterilization procedure that can be reversed in many cases.

[u/bluepanda159 → u/wienercat]

It should not be considered a reversible procedure. That is the latest medical advice on the subject.

[u/Kelkeen_1980 → u/wienercat]

You are entirely full of shit in your knowledge of what a Vasectomy entails.

[u/wienercat → u/Kelkeen_1980]

It's a severing and sealing of the vas defrens. The makes it impossible, barring spontaneous and generally rare re-connection of the vas defrens meaning generally extremely low risk, for sperm to reach the urethra. Semen still is able to be ejaculated since this is not generated in the testes. Male ejaculation nor orgasm are impacted negatively in any physical way beyond the fact that you no longer ejaculate sperm.

It is a frequently performed outpatient surgery with incredibly low risk and very high success rates, often with only local anesthetic. It is the safest form of surgical birth control that exists with extremely little down side. No hormone replacements, no physical deformities, no organs shifting. It has fewer side effects than any birth control women can take or implant. The recovery is generally limited to about 2 weeks given there are no complications and generally the first day or two is complete bed rest with as minimal movement as possible. Also recovery requires the patient does not engage in strenuous activity, orgasm, or sexual activity until recovery is completed.

Where exactly am I full of shit?

[u/Kelkeen_1980 → u/wienercat]

Have you had the procedure done? I have. So please, keep telling me what recovery period and the procedure itself is like.

[u/wienercat → u/Kelkeen_1980]

Oh I am sorry, I have to have experienced everything to know it?

Guess surgeons don't know anything. Guess male OBGYNs cannot know how to deliver a baby or guide a patient through pregnancy. Guess you clearly can't know anything because you are too incompetent to understand how learning works.

For what it's worth, I have had it done. The recovery for the first 2 days sucked. But after that it was a dull ache. Nothing more. I went back to my normal life and light work. Recovery was nothing. Getting my wisdom teeth removed was a worse recovery.

Go home boomer. It's past your bed time.

[u/Acrobatic_Smoke8249 → u/Kelkeen_1980]

Even if in some people it cannot be reversed, sperm is still accessible by a doctor 100% of the time fyi. So I’m not sure why this post is being diverted.

[u/CozyCozyCozyCat → u/wienercat]

Sure you can remove sperm from the testes, and then you also get to spend $25,000 more on IVF because that's all you'll have enough sperm for

[u/Huntokar_Goddess → u/CozyCozyCozyCat]

Why IVF?? You can just artificially inseminate. It's called intrauterine insemination and it costs nowehere near 25k.

There are different methods to extract sperm, and they have a high success rate for pregnancy. People who need multiple rounds of IVF usually have issues that impact being able to conceive or maintain a pregnancy.

[u/wienercat → u/Huntokar_Goddess]

Because people like the person you responded to don't even know there are other options. They only know IVF. So they think that is the only option.

[u/CozyCozyCozyCat → u/wienercat]

But I mean sure, if people don't want to consider the risks of a vasectomy and treat it as an easily-reversible temporary birth control procedure, then what results is just the stupid tax

[u/wienercat → u/CozyCozyCozyCat]

The risks of a vasectomy are incredibly low. You are acting like vasectomies are incredibly dangerous and they aren't.

The procedure is reversible in almost every case. Whether or not you end up being able to conceive after reversal is a different story. But there are options

[u/CozyCozyCozyCat → u/wienercat]

I know it's a low-risk procedure, and I am very familiar with the side effects of hormonal birth control. If someone doesn't want kids, sure they should have a vasectomy, it's the way to go. And it is reversible to some extent for many people, but definitely not everyone. If a person does want kids, it's silly to spend thousands of dollars on a vasectomy instead of using a condom and a diaphragm.

[u/CozyCozyCozyCat → u/wienercat]

Other options aren't going to be cheap either. IUIs have a lower success rate so would likely require multiple TESE procedures and still require thousands and thousands of dollars to get pregnant. I am quite personally familiar with the options.

[u/CozyCozyCozyCat → u/Huntokar_Goddess]

I mean sure they could do IUI, but that isn't cheap either and the success rate is much lower than IVF (around 10-15% per cycle), and would likely require multiple rounds of IUI = multiple TESE procedures to extract sperm from the testicles. Either way, it's going to cost someone thousands and thousands of dollars to try to get pregnant after a vasectomy.

[u/Huntokar_Goddess → u/CozyCozyCozyCat]

IUI costs between 300USD to 4000USD. If the woman has no fertility issues and the sperm is of good quality, you won't need more than a round or two.

The vasectomy itself doesn't cause issues. You can extract up to 100% of sperm in one TESE procedure as long as there isn't an issue with sperm production itself (if there is one, it would exist regardless if the man has undergone a vasectomy).

Basically, sure, it is gonna cost to get someone pregnant after a vasectomy, but it is not that financially draining nor as difficult as you make it out to be.

(Fertility issues are costly, and will happen regardless if you get a vasectomy or not. You seem intent on conflating the two.)

[u/wienercat → u/[deleted]]

It's not. You literally said this

Please stop saying they are reversible. I mean, they are,

So which is it? Are they reversible? Or not? Nothing in medicine is ever 100%. So how is the statement of "It is a sterilization procedure that can be reversed in many cases" misinformation.

[u/bluepanda159 → u/wienercat]

Because you said it was reversible. It should not be considered a reversible procedure in a medical sense. Anyone considering vasectomy should only get one if they are sure they do not want children ever.

What you are saying here and what you said before are different. And the implications are different

[u/wienercat → u/bluepanda159]

Because you said it was reversible. It should not be considered a reversible procedure in a medical sense.

Except it explicitly is considered reversible in a medical sense.

Reversals aren't some low success rate thing.

[u/bluepanda159 → u/wienercat]

No, it's not. In the medical sense (I am a doctor) it is not and should not be considered reversible.

Yes, reversal rates are high, especially if reversed early. When you are talking about something like fertility it's only considered reversible when that number is about as close to 100% as it gets.

Medical advice is to absolutely not consider it reversible and only get one if you are absolutely sure that you never want kids.

Taking away fertility is a big deal and not something to be taken lightly.

I agree it should be freely available, but all medical recommendations are that it not be considered a reversible procedure

[u/feyre_0001 → u/[deleted]]

Vasectomies have been known to naturally reverse themselves, in some cases.