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Permanent Sterilization

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For women who do not want to have children or do not want to have additional children, may consider sterilization as a permanent method of birth control.

Sterilization is the process of closing the fallopian tubes. The procedure is commonly referred to as having one’s “tubes tied” and professionally referred to as a tubal occlusion.

When the fallopian tubes are closed, the egg cannot move from the ovary to the uterus. When the sperm cannot reach the egg for fertilization, the ability to have children is removed.

Sterilization is a highly effective way to prevent pregnancy. However, while extremely rare, a woman can become pregnant after a tubal occlusion. The possibility of a women becoming pregnant within a year of the procedure is less than 1%. The probability of a women becoming pregnant after a tubal occlusion after 10 years is less than 4%.

CAUTION

Sterilization is permanent method of birth control and is not meant to be reversible. Before having the procedure, women and couples must be certain that they do not want children in the future. If the sterilization procedure is performed and the woman or couple change their mind after the operation, a reversal surgery may be performed (along with assisted reproductive technology) to attempt pregnancy. However, these procedures are expensive, may not be covered by insurance and there is no guarantee of pregnancy.

STERILIZATION METHODS

There are three ways that sterilization for women can be performed: minilaparotomy, laparoscopy, or hysteroscopy.

Minilaparotomy is a procedure where a small incision is made in the abdomen and the fallopian tubes are brought up through the incision. A small section of each tube is removed or both tubes are removed completely. Less often, clips are used to close off the tubes. This approach is frequently is used after having a baby.

Laparoscopy is a type of surgical procedure that uses a device called a laparoscope to view the pelvic organs. The fallopian tubes are closed off using instruments passed through the laparoscope or with another instrument inserted through a second small incision.

Hysteroscopic sterilization does not require incisions in the skin. It can be done with local anesthesia and as an in office procedure. Small devices are placed into the openings of the fallopian tubes. The devices cause scar tissue to form that block the fallopian tubes. After having the procedure, it takes 3 months for the scar tissue to form. During this time, another form of birth control should be used to prevent pregnancy. A test called hysterosalpingography must be done to ensure that the tubes are blocked before it can be used as the only method of birth control.

RISKS

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A risk common to all female sterilization methods is that when a pregnancy does occur after sterilization, there is an increased chance that it will be an ectopic pregnancy. An ectopic pregnancy is the situation when the fertilized egg implants outside of the uterus and is life threatening to the mother.

FOR MEN

A vasectomy is a procedure performed on men to block the movement of sperm from the testicles during ejaculation. Normally, sperm is mixed with semen and moves from each testicle through a tube, called the Vas deferens.

During a vasectomy, one or two small openings are made in the skin of the scrotum. Each vas deferens is pulled through the opening until it forms a loop. A small section is cut, tied, or clipped out of the loop and removed. The two ends may also be sealed with heat causing scar tissue to grow and further block the release of sperm. Each vas deferens then is placed back into the scrotum.

It takes up to 4 months for the semen to become totally free of sperm. A couple must use another method of birth control or avoid sexual intercourse until a sperm count confirms that no sperm are present.

A vasectomy generally is considered to be safer than female sterilization and requires only local anesthesia. Also, there is no increased risk of ectopic pregnancy if the vasectomy fails. Risks of vasectomy include minor bleeding and infection. Major complications are rare.

SUMMARY

Women who are considering permanent sterilization should call Rosemark Women Care Specialists and make an appointment with one of our board certified ob/gyn physicians.