Vasectomy in the absence of paternity

A pre- and post-pandemic Canadian cohort analysis

Authors

  • Gavin Hughes Temerty Faculty of Medicine & Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
  • Ethan Grober Division of Urology, Department of Surgery, University of Toronto, Women’s College Hospital & Sinai Health System
  • Tiange Li Division of Urology, Department of Surgery, & Institute of Medical Sciences, University of Toronto
  • Yonah Krakowsky Division of Urology, Department of Surgery, University of Toronto, Women’s College Hospital & Sinai Health System

DOI:

https://doi.org/10.5489/cuaj.9461

Keywords:

Vasectomy, Sterilization, male contraception, hormonal contraception, ethics, vasectomy, reproductive system, COVID-19 pandemic, socioeconomic factors

Abstract

Introduction: 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.

Methods: 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 cohort. No vasectomies were performed in 2020–2021 due to COVID-19 restrictions.

Results: 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.

Conclusions: 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.

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Author Biographies

Gavin Hughes, Temerty Faculty of Medicine & Institute of Biomedical Engineering, University of Toronto, Toronto, Canada

BHSc from Queen's University

MD-MEng 2028 Student at UofT

Ethan Grober, Division of Urology, Department of Surgery, University of Toronto, Women’s College Hospital & Sinai Health System

Dr. Ethan Grober is a native of Toronto, Canada.

He serves as head of the Division of Urology at Women's College Hospital.
Dr. Grober is an Assistant Professor within the Division of Urology at the University of Toronto. He is a full time staff urologist at the Mount Sinai Hospital and Women’s College Hospital.

Dr. Grober is a fellowship-trained specialist in Male Reproductive Medicine and Surgery.

Dr. Grober’s clinical activities focus on vasectomy reversal, microsurgery, genital reconstruction, male reproductive and sexual medicine, and testosterone deficiency.

Dr. Grober’s research activities are directed towards the achievement of excellence in surgical education.

Tiange Li, Division of Urology, Department of Surgery, & Institute of Medical Sciences, University of Toronto


MD (UofT), Urology resident (UofT)

In the surgeon scientist training program working towards MSc. 

Yonah Krakowsky, Division of Urology, Department of Surgery, University of Toronto, Women’s College Hospital & Sinai Health System

Dr Krakowsky MD FRCSC is a urologist and sexual medicine surgeon on staff at Women’s College Hospital and Mount Sinai Hospital. Dr Krakowsky is a surgeon-educator at the University of Toronto and is the program director for the urology residency program.

Dr Krakowsky completed his medical training and urologic surgery residency at the University of Toronto. He then completed a fellowship in Sexual Medicine and Surgery at Harvard Medical School under Dr Abraham Morgentaler. Dr Krakowsky is an active member of the International Society for the Study of Women’s Sexual Health (ISSWSH) and the Sexual Medicine Society of North America (SMSNA).

Dr Krakowsky’s clinical and research interests are in peyronies disease, erectile dysfunction, female sexual medicine, and increasing access for trans surgery in Canada.

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Published

2026-02-13

How to Cite

Hughes, G., Grober, E., Li, T., & Krakowsky, Y. (2026). Vasectomy in the absence of paternity: A pre- and post-pandemic Canadian cohort analysis . Canadian Urological Association Journal, 20(6). https://doi.org/10.5489/cuaj.9461

Issue

Vol. 20 No. 6 (2026): CUAJ June

Section

Original Research

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