Vasectomy is typically performed as an outpatient procedure using local anesthetics. The technique employed for occlusion of the vasal lumina may influence the incidence of recanalization. Suture ligature, still the common method employed worldwide, may result in necrosis and sloughing of the cut end distal to the ligature. Hematoma is the common complication of vasectomy, with an average incidence of 2%. Sperm granulomas form when sperm leak from the testicular end of the vas. Sperm are highly antigenic, and an intense inflammatory reaction occurs when sperm escape outside the reproductive epithelium. The concept of male hormonal manipulation for contraception predated the era of female hormonal contraception by 20 years. Progestins have been used in multiple small studies for suppression of spermatogenesis and testosterone production in men. Along with hormonal manipulation, immunocontraception appears to offer reasonable hope for a nonsurgical contraceptive option in men.

In 1972 Kenyon sent a letter to the British Medical Journal describing a patient with epilepsy treated with phenytoin (PHT) who became pregnant despite taking usual amounts of oral contraceptive (OC) pills. Following the initial case report by Kenyon, three other cases of OC failure were cited by Janz and Schmidt. Antiepileptic drug (AED)-induced clearance and increased sex-hormone-binding globulin (SHBG) may result in lower free testosterone with resultant decrease in libido, potency and spermatogenesis. Most pharmacokinetic studies have suggested the estrogens and progestins in the OC pill were cleared approximately twice as rapidly in women patients receiving enzyme-inducing AEDs compared to normal controls. The safest way of dealing with the problem of unwanted loss of OC effectiveness is to avoid AEDs that affect the clearance of sex steroids. Increased clearance and possible loss of contraceptive effect is found with felbamate (FBM) and oxcarbazepine (OXC).