By Gerald F. Joseph, Jr, MD,
President, The American College of Obstetricians and Gynecologists
Sterilization—specifically tubal sterilization in women and vasectomy in men—is the most common method of birth control used in the US. Many couples choose sterilization because it is an extremely effective permanent form of contraception, leaving less than a 1% chance of pregnancy.
Most women are sterilized with a procedure called tubal ligation (“having your tubes tied”). The fallopian tubes are the pathways between a woman’s uterus and ovaries that allow sperm to reach an egg and fertilized eggs to reach the uterus. In this procedure, both fallopian tubes are closed by tying, banding, clipping, or sealing them with electric current. Tubal ligation is most often performed with laparascopic surgery—a technique that requires only a small incision in the abdomen. Newer sterilization methods, often performed in a doctor’s office, use tiny coils that are inserted into the fallopian tubes and cause scar tissue to develop, blocking sperm and egg from meeting.
Tubal sterilization can be performed immediately after childbirth or as a separate out-patient procedure at another
time. Recovery is typically short and
should not add to a woman’s hospital stay if performed after delivery.
In men, sperm travels through the vas deferens, two small tubes located inside a man’s scrotum, to join the other fluids that make up his semen. A vasectomy prevents the flow of sperm by tying, cutting, clipping, or sealing the vas deferens. Vasectomy can be performed in a doctor’s office, clinic, or hospital and does not require a hospital stay. Some newer vasectomy techniques can even be performed without a single stitch.
The risk related to sterilization is low. In women, complications generally involve those common to any surgery, such as infection, bleeding, or problems related to anesthesia. Men may experience some temporary swelling and discomfort in the scrotum. Sterilization does not affect men-struation in women or sexual function in either sex.
Even after sterilization, a very small risk of pregnancy still remains. Vasectomy and some forms of tubal sterilization may not immediately protect against pregnancy. A backup method of contraception, such as condoms, may be necessary for the first few months following the procedure. Sterilized women should contact their doctor if they miss a period because of a higher risk of tubal (ectopic) pregnancy.
If you are considering sterilization, be sure that you do not want children in the future. You should also talk to your doctor about your reasons for wanting sterilization and the risks and benefits involved.