Vasectomy in the absence of paternity A pre- and post-pandemic Canadian cohort analysis

Vasectomy is a safe and effective method of male sterilization, traditionally conceptualized in practice to be pursued by older, partnered fathers; however, shifting socioeconomic, political, and cultural landscapes may be contributing to changes in the demographic profile of the vasectomized patient. Specifically, this study sought to compare the proportion of men undergoing vasectomy with no prior children between pre- and post-COVID pandemic periods. Secondary outcomes included differences in age, relationship status, and overall vasectomy volume trends.

We conducted a retrospective chart review of patients undergoing vasectomy by two high-volume urologists in Toronto, Ontario, from 2018-2024. Patients were divided into two cohorts: pre-pandemic (2018-2019) and post-pandemic (2022-2024). Demographic variables, including age, relationship status, and number of children, were collected and analyzed using multivariable logistic regression to identify whether childlessness was independently associated with the cohort. No vasectomies were performed in 2020-2021 due to COVID-19 restrictions.

A total of 565 patients were included (152 pre-pandemic, 413 post-pandemic). The proportion of men without children rose significantly from 6% to 16% post-pandemic (p=0.04). The mean number of children decreased from 2.1 to 1.8 (p=0.03). Single men were also significantly more likely to be childless; however, age and relationship status did not differ significantly between groups.

The demographic profile of vasectomy patients in Canada is evolving. Post-pandemic, more childless men are pursuing sterilization, challenging traditional assumptions about vasectomy candidacy and highlighting broader changes in reproductive decision-making among men.