 In our previous videos we discussed about different methods of contraception and a contraception simply means birth control and in this video let us explore a new method of birth control which we obtain through some kind of surgery and therefore this method is called the surgical method of birth control. Now from the name itself you can guess that there is some kind of surgery involved in it. So now a very common question that would arise is that which part of the body are we going to perform the surgery in? Which part of the body? What do you think? Well the next question that may pop up is that are we going to perform the surgery on a male or a female? So let us answer this question. So talking about the body part this surgery has to be performed on the reproductive systems. Okay so are we going to chop off the entire reproductive system? And will a person even survive if the reproductive system is removed? Well later in the video we will see that the procedure takes place in a small part of the reproductive system and not the entire reproductive system as a whole and also you may probably know that reproduction is not necessary for survival of an individual. So even if the reproductive ability is taken away a person still survives. Okay so coming back to the next question are we going to perform it on a male or a female? Well this procedure is done both on male and female. So let us first discuss about the surgical method in case of male and for that let us bring in the male reproductive system on the screen. And let me quickly walk you through the male reproductive system they have a pair of testes. So here is a testes and we can also call them the factories where the sperm cells are manufactured. So now let's talk about the part that the sperm has to travel. So from the testes it moves into this part it is called the epididymis. It comes from a Greek word and that is why it seems very fancy but it simply means to sit on top of the testes. Now the epididymis may look like a solid mass of tissue on top of testes but actually these are highly coiled tubes compactly put on top of testes. And if we zoom in we will see that it looks something like this. If we measure the length of this highly coiled tube it comes around 6 meters and you will be amazed to know that the sperm requires 14 days to cross this epididymis. Interesting right? So after crossing the epididymis the sperm enters a different tube and this long tube is called Vaas Difference or Vaasa Differentia another fancy name. So in biology you will always have these fancy names and long terminologies. So what you can always do is that divide the term into different smaller parts. So as we are talking about surgical method how about we perform a surgery of this word. So anyways this word is already divided into two Vaas and Difference and if you look up the meaning it will always make sense. So Vaas comes from a Latin word which means vessel and Difference comes from another Latin word that means to carry away. So this long vessel that you see is made to carry away the sperms. Make sense right? So after the Vaas difference the sperm enters another tube which we call the urethra and this tube as you can see it passes down the penis and through this tube the sperm finally gets out of the male's body. Now urethra is again taken from a Greek word which simply means to urinate. So as you probably know that urethra is a passage through which male not only ejaculate their semen but they also can urinate through it. So this passage is a common passage both for urine and for semen ejaculation right? So that is where this tube got its name from. So now as we are talking about surgical method of contraception our goal is to somehow surgically remove a part of this male reproductive system so that the sperm can never, never escape the male's body. So pause the video for a while and take a moment to think about which part of this male reproductive system should we cut and remove. So are you thinking of removing the testes? Because this is the place where the sperms are even formed and if the testes is removed the problem is solved. There will be no sperms formed and there will be no question of sperm leaving the male's body. But wait testes has cells that also produces a very special hormone male hormone called testosterone and this hormone strongly impacts the male's libido or male's sexual desire. Now a good contraceptive method should be something that stops a person from having more babies. But it should not impact anything else in the body but taking off the testes will stop the person from producing a very very vital hormone for male. So taking testes would be a very bad idea. Now if we do not take off the testes the sperms will continue to be formed inside it right? So what can we do? How about we surgically remove a part of the passage that it follows so that the road is blocked somewhere. So let's talk about this road the urethra. Now the urethra is also required to urinate we cannot block this passage. How about the vast difference? Vast difference seems like just a connecting passage from the epidermis to the urethra. So seems possible. But what about epidermis? Well epidermis is highly coiled and is very closely stuck to the testes. So we may accidentally puncture the testes as well right? So let's stay a little away from testes and let's stay a little away from urethra. The vast difference seems like a sweet spot. Now by vast difference I mean this entire passage that I have made in blue and it will be surgically cut somewhere here and it will be cut and tied with surgical threads so that the sperm that is flowing through it will not be allowed to move in further. It will be blocked here right? And definitely the surgery should be performed on both the vast difference so that the sperms from both the testes are blocked. And this surgical procedure in case of mail is called vasectomy. Again here a vast comes from vast difference and ectomy means excise or to surgically remove something. So anywhere you get this ectomy it simply means cutting and removing something. So in mail it is called vasectomy. Now when I learnt about it for the first time I was curious to know what happens to the sperm when it reaches this point because after all we are not stopping the sperm production right? Will it like produce a traffic jam kind of situation? Because in every ejaculation the mail ejaculates not one, not two, not thousands but millions of sperm in just a single ejaculation. So you can imagine the quantity of sperms that are produced by the testes. Now where do all those sperms go? Because the road is blocked it cannot go down to the urethra. So where are the sperm cells? Because again we are not stopping the sperm production here. And when I read about it I found that the sperm cells have a definite life span and after that they degenerate or there are phagocytic cells in here that phagocytos the sperm cells. Alright now that we know what happens to the sperm cells here tell me about the sperm cells that were lucky enough to have crossed this part of the vast difference before the surgery. So the sperm cells say that are present here what happens to them? Well their path is clear there is no obstruction they can go out of the penis whenever there is an ejaculation. And therefore even after the surgery a mail is asked to use some other kind of protection like a condom during sexual intercourse because the sperms in here can remain viable up to three months. And talking of ejaculation and that too after vasectomy where do you think all the ejaculatory fluid coming in from? Because it is for sure nothing coming from the testes because we have blocked the passage so where is all the fluid in the ejaculation coming in from? Well we also call the ejaculatory fluid the semen. So where is the semen coming in from? So we should know that it is only 10% or even less than that I should say 6 to 7% or 8% of the semen is contributed by the vast difference. So the rest of the fluid where is that coming from? It is coming from these small small glands that you see they all release their secretions into this urethra and they together form something called a semen. So the majority portion is contributed by these two small glands that you see we call it the seminal vesicle. So the seminal vesicle contributes around 60% of the ejaculatory fluid. Then next highest percentage is 28% almost by the prostate gland. So we have a prostate gland here. So this is the prostate gland that contributes the second major portion of the ejaculatory fluid. Then around 4 to 5% by the bulbu urethral gland. These two tiny glands here these are called the bulbu urethral gland. So they together compose the ejaculatory fluid and that is where the fluid comes in from after vasectomy. Well we definitely do not get this 6 to 7% that comes from the testes but the rest is always there in the ejaculation. Now you need not worry about what these different glands are, what are they secreting, why are they important. Well we can keep this for another video. But all I want you to understand is that even after vasectomy there is ejaculation and these are the glands that contribute to the ejaculatory fluid. So this was all about the surgical method of contraception in case of male. Now let's move on to the female and for that we have the female reproductive part here. And the female reproductive part consists of a pair of ovaries. So let me label one this is an ovary and alternately these ovaries every month release an egg into this tube which is called the fallopian tube. Now if there is sexual intercourse and the sperms are released into the vagina the sperms swim all the way up to the egg through this tube and fertilizes the egg and that causes pregnancy. So just like we block the passage of sperm in vasectomy we do the same in case of female. So we block the passage of sperm here by surgically removing a part of this fallopian tube and tying it and it will look something like this and if we break this fallopian tube connection the sperm can never reach the ovum and this process in female is called tubectomy. As we discussed ectomy means surgically removing something and tube signifies this fallopian tube. Now after tubectomy will women have a normal menstrual cycle? Well the answer is yes because as every month the ovaries prepare to release an egg the endometrium also prepares to take care of an embryo just in case the egg might fertilize and the uterus may need to take care of a developing baby inside it. But after some time as the uterus fails to receive the embryo the endometrial lining is shed off along with blood and that rushes out as menstrual bleeding. So even after tubectomy a women will have a normal and a regular menstrual cycle. Now for all the different type of contraceptive methods that we have discussed in our previous videos like the barrier method or the hormonal method in all those different methods if the couple decides to have a baby if they decide to conceive then they can stop using those contraceptive methods and try having a baby. But when it comes to the surgical method that is tubectomy and vasectomy in case of male the success rate of reversing this process is very low. Therefore the surgical method should be the last option of contraception and should be done only after a couple is very sure they did not require any more babies. And if someone decides to go ahead with this procedure then these are very inexpensive procedures vasectomy especially is less expensive than tubectomy and if we talk about India most government clinics offer this surgical methods for free.