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Not quite 100%.

> The early failure rate of vasectomy (presence of motile sperm in the ejaculate at 3–6 months post-vasectomy) is in the range of 0.3–9% and the late failure rate is in the range of 0.04–0.08%.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110415/

8 out of 10,000 men is still a very low failure rate, although keep in mind that typically failure rates for contraceptives/sterilization are per annum.

So if you get a vasectomy with a 0.08% failure rate and then have sex for 30 years ... 0.08% * 30 = 2.4%.



To be fair, that's still a better 30-year failure rate than most contraceptives:

Typical hormonal IUD annual failure rate = .1% [1].

.1% * 30 years = 3%.

Considering that one would have to get the hormonal IUD replaced (painful!!) every 3-8 years [1], while vasectomies only require check-ups two times after the procedure (not painful) after 1-2 months, and at one's discretion afterwards, that's a way better value proposition.


Generally the control for this is 3 months after the procedure you get a fertility test and a secondary procedure if needed.




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