women s health issues
Permanent Contraception
Introduction
Permanent contraception involves making a person incapable of reproduction. Disrupting the tubes that carry sperm or the egg ends the ability to reproduce. This form of contraception should always be considered permanent, although the procedures can sometimes be reversed. Vasectomy is a short procedure for men, done in the doctor’s office. The procedure for women (often called tubal sterilization) is more complicated and may be done using a thin tube inserted through a small incision in the abdomen or done through a larger incision in the abdomen. In the United States, about one third of all married couples who use family planning methods, particularly if the woman is over 30, choose permanent contraception. For men, the procedure is vasectomy. For women, permanent contraception procedures can be done using a thin tube inserted through a small incision in the abdomen (laparoscopy) or through an incision in the abdomen (minilaparotomy—see below). Permanent contraception for women is often called tubal sterilization, which also refers to a specific procedure, the so-called tying the tubes. Sterilization procedures are very effective. The percentages of women who become pregnant after 1 year are For vasectomy: 0.15% For procedures involving the fallopian tubes: 0.6% One year after their partner has a vasectomy, fewer than 0.2% of women become pregnant. About 1.1% of women become pregnant during the 5 years after their partner has had a vasectomy. This form of contraception should always be considered permanent. However, if couples change their minds, an operation that reconnects or opens the appropriate tubes (called reanastomosis) can be done to try to restore fertility. Its success depends in part on which procedure was used. Reanastomosis is less likely to be effective in men than in women. For couples, pregnancy rates are about 26% after reanastomosis in men. For women, the likelihood of reversing a permanent contraception procedure depends on the following: Which procedure was used How old the woman is How much of the tube remains How much scarring has occurred What fertility test results in the woman and her partner are If reanastomosis is unsuccessful, conception may be possible with In vitro (test tube) fertilization (IVF) . 