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According to a study conducted by EPI-PHARE, the annual use of vasectomy in France between 2010 and 2022 soared from 1940 procedures to 30,288 procedures. Noémie Roland, MD, PhD, an epidemiologist and coauthor of the study, commented on these findings. It is noteworthy that for the first time in France, in 2021 and 2022, there were more male sterilizations than female sterilizations.

Overview of Practice

On February 12, the Scientific Interest Group on Epidemiology of Health Products ANSM-Cnam EPI-PHARE published an overview of the practice of vasectomy in France between 2010 and 2022. "Previously, we only had partial studies that reported on the incidence of vasectomy for a year and field reports from urologists who observed more requests, from increasingly younger men," said Roland, an epidemiologist at CNAM within EPI-PHARE. "So, we decided to count the number of vasectomies in France over 12 years and across the population."

To do this, the researchers relied on information from the National Health Data System. "This allows us to access information on reimbursed procedures, including surgical procedures, and to know the age, department where the care is provided, affiliation with the CMU-C insurance program, and the deprivation index. This gives an indication of the socioeconomic context, although it is not enough to characterize everything," said Roland.

Multiplication by 15

The number of vasectomies among men aged 18-70 years from 2010 to 2022 was thus counted. "We wanted to compare male and female sterilization. So, we did the same work on women aged 18-70 years who resorted to tubal ligation or intratubal implant."

The study emphasized that "109,544 vasectomies were performed on men aged 18-70 in France between 2010 and 2022. At the same time, 398,080 female sterilizations were recorded. The number of vasectomies increased each year during the study period, from 1940 vasectomies in 2010 to 30,288 in 2022, a 15-fold increase. Comparing to the National Institute of Statistics and Economic Studies (INSEE) population of men aged 20-70 years, the incidence of vasectomy per 100,000 men aged 20-70 years in France increased from 9.8 in 2010 to 149.5."

"This trend appears to be confirmed in 2023 with our preliminary figures. We have recorded over 20,000 vasectomies in the first 6 months of 2023," said Roland. The researchers can only speculate on the causes of this exponential increase. Roland suggested "an evolution in urological discipline, with an improvement in surgical technique, which is now faster, performed on an outpatient basis, with a smaller incision and less intimidating than before." She noted that the French Health Authority recommendations are recent (2019), as are those of the French Association of Urology (2023).

Increasingly Younger Men

Men undergoing vasectomy were on average younger between 2010 and 2022 (from 44 to 41 years on average). Over 50% were between 40 and 50 years. They also appeared to correspond to the most advantaged socioeconomic profiles. "Internationally, generally, where countries have a high prevalence of vasectomy, they also have high socioeconomic indicators. In global studies, the more favored men are, the more likely they are to undergo vasectomy, whereas it is the opposite for women: The more disadvantaged they are, the more likely they are to undergo tubal ligation," explained Roland. "We need more sociological data on the profiles of men who undergo vasectomy. We do not have access to their offspring, in particular."

The share of national vasectomy practice was highest in the Auvergne-Rhône-Alpes region (15.7%), Pays de la Loire (11.8%), and Nouvelle-Aquitaine (10.2%). Relative to the population of men aged 20-70 years (INSEE figures), Pays de la Loire and Brittany had the highest rates of vasectomy practices.

Gender Differences

Meanwhile, the number of female sterilizations (tubal ligation or Essure implantation from 2010 to 2022) was halved between 2013 and 2022 (from 45,138 sterilizations in 2013 to 20,325 in 2022) after an increase between 2010 and 2013. For the first time in France, in 2021 and 2022, there were more male sterilizations than female sterilizations. In 2022, three male sterilizations were performed for every two female sterilizations. "Only nine other countries in the world have this type of ratio," Roland said. "We have seen a decline in female sterilizations from 2016 and 2017, with the publicity of health issues related to the Essure implant, which was banned in 2017. Moreover, tubal ligation is a more burdensome operation than vasectomy," she added.

Complications Limited, Moderate

French figures run counter to those observed worldwide. "In the United Kingdom, for example, there was a decrease from 30,000 to 10,000 vasectomies per year over 10 years. Nevertheless, the figures are incomparable with the United States, where they still perform 500,000 vasectomies per year," said Roland.

Furthermore, the results are reassuring regarding the safety of the procedure. "We looked at the use of painkillers in the year after vasectomy and did not observe a significant increase. One can cautiously think that complications are limited and moderate."

However, Roland observed that "vasectomy is not effective immediately. It takes 3-4 months to be sure of its effectiveness and to perform a sperm count. However, only two thirds of men do this. We can do better in terms of follow-up."

Roland's team would like to repeat these surveys to see if the trend is confirmed and to study the evolution of the use of condoms reimbursed by social security. "It is still mainly women who bear the burden of contraception. It is interesting to study how this burden can be shared within the couple," she concluded.

This story was translated from the Medscape French edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.