I had a vasectomy in my 20s after the trauma of my sons' births
George Sandeman
Alex West
Alex West says he remembers the months after the births of his two sons as "grey"
Alex West was left harrowed by the difficult labour his wife endured for their first child. When it came to their second, he hoped for a much smoother arrival.
The birth did go better for his wife - but not for him.
"I had a panic attack and broke down. I hadn't been able to - I didn't have the ability to - process that," Alex says.
Unresolved trauma from his wife's first labour and his subsequent postnatal depression meant Alex didn't want to continue with the couple's plan to have four children.
Vasectomies even safer than reported, doctors say
He remembers the months after the births of his two sons as "grey" - life was devoid of colour and filled with people telling him that being a father must be a fantastic experience.
"I didn't feel this love and connection that everybody says I should have," Alex says.
Not wanting to repeat the experience, he and his wife agreed to stop at two kids. Given he was the driving force behind the decision, he felt it was "wrong to put the onus on my wife" to take a contraceptive.
So like thousands more men in England have done in recent years, Alex chose to have a vasectomy.
The procedure involves the cutting and then clamping or sealing of the vas deferens, a tube on each testicle that carries sperm to the urethra. It's colloquially known as the snip.
How a vasectomy works
Some 26,385 vasectomies were performed at hospitals and clinics during 2024-25, according to data compiled by NHS England. This was 16% more than in 2023-24.
Men aged 35-39 had more procedures than any other age group, about 8,400 in 2024-25.
There had also been a slight rise on the previous year in younger men choosing to have the snip - about 950 vasectomies were performed on men aged under 30 in England during 2024-25.
Fears about pregnancy
Alex, a mortgage broker, decided in his late 20s to have the procedure but his NHS doctor urged him to wait until he turned 30 in case he changed his mind.
When the appointment came in May 2024, he and his wife took the train from their Kent home to the London clinic.
The procedure was quick and painless says Alex, now 33. "I put my headphones on and I listened to about three songs before they said it was all done.
"Ridiculous - crazy quick."
Sam Knight
Sam Knight decided to have a vasectomy after a woman he was dating became pregnant
Sam Knight, who's from the US, says he knew he didn't want to have children.
"I was putting myself in situations where kids could be a potential option and that really started to, kind of, freak me out," Sam says.
When his then-partner became pregnant, she chose to have an abortion and Sam, aged 22 at the time, felt a change was needed.
"[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, like Alex, had to explain to clinicians why he wanted a vasectomy. Sam was advised the procedure should be treated as permanent, as it can only be reversed in some circumstances.
Strict criteria for reversals
Because he was asking for a vasectomy at such a young age, Sam had prepared for the questions his doctor was going to ask him: Don't you think you're too young to know you don't want kids? Could you change your mind in future? You do know reversals are expensive and aren't always successful?
"[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 took place a couple of months after he first contacted the clinic.
The questions from Sam's doctor were designed to ensure he was making a decision he could live with; men under 30 are more likely to regret a vasectomy, according to guidance from NHS Scotland.
Dr Sarah Salkeld, a former GP who is now a medical director for MSI Reproductive Choices, a group of clinics offering various contraceptives to NHS and private patients, says a vasectomy is "very safe and effective".
But she cautions it is important for men to "really think about" whether a vasectomy is right 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."
She says reversals are not routinely available on the NHS as there are strict criteria for having one.
The NHS website points out that other forms of contraception are available to men, including condoms and the fertility awareness method - avoiding sex or using condoms on the days when their female partner is most fertile.
Sam told his doctor that, while he loved kids and had a happy childhood himself, he wanted to stay focused on his job as a sound designer for video games.
Alex West
Alex and his wife initially planned to have four kids but after careful consideration stopped at two
"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."
Sam, now 25, says he envies those who do want to become parents because the experience "clearly has" beauty and love in it. But adds, "I find that in music and art and these things that I do."
The procedure in 2024 and the aftercare cost Sam, who was still on his family's health insurance policy, about $1,200 (£849) in total.
He's among fewer than 1% of men in the US aged 18-29 who have ever had a vasectomy, according to the National Survey of Family Growth, which analysed the responses of about 4,000 men in 2022-23.
Men in their mid to late 40s were most likely to have had one -15% said they had.
Sacrifices and uncertainties of being a parent
Sam experienced one bout of excruciating pain a week after the procedure, a known but uncommon side effect of vasectomies according to Dr Salkeld, but that subsided after a few hours.
He doesn't think this should put other men off having a vasectomy. "Overall, it is worth the money and it is worth the pain," he says.
Another man told us the sacrifices and uncertainties of being a parent - particularly how his children might turn out - drove him to have a vasectomy aged 27.
Back in Kent, the decision to get the snip felt like the fairest and most effective form of contraception available to Alex and his wife.
It was something they considered carefully over several months, knowing they no longer wanted more children.
"I absolutely adore my children," Alex says, particularly now 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."
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Alex West