Monday 10 December 2018

Women are used to calling shots on fertility - 'reversible vasectomy' will change this

The failure rate attributed to the humble condom is mostly the failure to take it out of its packet (or, let's be honest, to be too plastered to bother doing so)
The failure rate attributed to the humble condom is mostly the failure to take it out of its packet (or, let's be honest, to be too plastered to bother doing so)
Mary Kenny

Mary Kenny

Developments in contraception are constantly in progress, and the boffins seem optimistic with the latest breakthrough in male contraception - the "reversible vasectomy".

This consists of an impenetrable gel injected into the vas deferens - the male reproductive part that produces the sperm - and halts the procedure towards fertilisation, once so wittily illuminated by Woody Allen in his movie 'Everything You Always Wanted to Know About Sex', in which he played the role of a sperm hoping to hit the jackpot.

Vasalgel - the injectable gel - will thwart any such trajectory, and what is so promising about the treatment is that it's reversible.

Many men who might otherwise be inclined to apply for "the snip" hesitate to do so in case they might want more children in the future. Their marriage might break up. God forbid, but they might lose a child. They might simply change their mind about fatherhood, and the present operation to reverse vasectomy is not always reliable.

But Vasalgel will do just that - the barrier holding back fertility can be easily removed - and hey presto! It's as you were.

Adam Balen, professor of reproductive medicine at the British Fertility Society, considers it a significant advance - it's only been tried on monkeys and rabbits so far, but such trials are usually dependable.

It's amazing, however, how little attention contraception - either male or female - attracts these days.

"Reproductive rights" have come to mean "abortion rights", and when abortion is discussed, it's as though contraception, or fertility control before fertilisation, had never been invented.

We are repeatedly told that 12 Irish women a day are "forced" to travel to Britain to exercise "control over their bodies", as though there were no previous choices in becoming pregnant, and no other form of control over human reproduction.

But isn't the original view advanced by the birth control pioneer Marie Stopes that taking precautions before an unwanted pregnancy occurs is always better than abortion still worthy of respect?

So, surely any improvement or advance in genuine fertility control is a good thing - and if a reversible vasectomy is an option for men and fathers, then that adds to the menu of choice for couples and families.

Ah, but many of the issues arising in the field of fertility are often more psychological than anatomical.

Contraception and fertility control themselves are firstly about motivation - any birth control practitioner will admit that. The failure rate attributed to the humble condom is mostly the failure to take it out of its packet (or, let's be honest, to be too plastered to bother doing so).

Then there's the question of power. What made the female contraceptive pill such a unique innovation in human fertility and the relationship between men and women was that, for the first time ever, it placed unequivocal and discreet power over fertility with women alone.

Other methods of birth control had either resided with the man, or required co-operation and evident knowledge between the couple. Champions of marriage thought this a good thing - that a couple should co-operate over birth control and share it with one another. This was "conjugality".

The Catholic Church's system of "natural family planning", involving the safe period, was advocated as being a conjugal endeavour, with the man respecting the woman's natural cycles.

But the female pill gave all the power to women. A woman could take the pill without a man's knowledge or consent. If she wanted to, she could pretend she wasn't getting pregnant because it just wasn't happening. She could also stop taking the pill if she wanted, without any man knowing that either, and if a pregnancy occurred she could blame "laboratory error". Or she could tell him he could like it or lump it.

This was a power which became a launching-pad for women's liberation - the power to rule fertility without male control.

Yet one of the obstacles in advancing and developing a "male pill" is that there isn't quite the same psychological will to make a success of it. Some progress has been made, but the side-effects are considered tiresome and the effectiveness patchy.

Some women say they wouldn't "trust" a man who claimed he was on the male pill.

While some men are praised for having a vasectomy - often for the altruistic reasons of sparing their wives the responsibility and sometimes burden of contraception - I have also encountered women who saw it as the man "withholding" fatherhood.

It would seem that women have grown accustomed to the power of making their own decisions about fertility, and not all are at ease with men repossessing it.

Ideally, the advocates of marriage and serene coupledom are right. In a perfect world, a loving couple are co-operative, share their values and respect each other's preferences. That perfect world doesn't exist, though it's never any harm aspiring to perfection.

In reality, marriage and relationships are often a struggle for power and dominion, in which men have been known to resort to force and coercion, and women to parry with guile and manipulation.

The issue of fertility can be part of that conjugal power struggle - who has the power?

The reversible vasectomy could be another choice for couples - or another element in the conjugal contest over who calls the shots.

Irish Independent

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