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Sterilization

Updated: Jan 24

What is Sterilization?


According to the American College of Obstetricians and Gynecologists (ACOG), sterilization can be defined as a “permanent method of birth control” for individuals who no longer wish to have the ability to reproduce and have children.

There are two major methods, one for females and one for males. The common procedure for females is called tubal ligation, which involves disrupting the fallopian tubes. For males, the common procedure is a vasectomy involving the vas deferens.


Tubal Ligation


Procedure

This image depicts the three different methods that could be used when performing a tubal ligation. The first is a cauterization in which the tubes are cut and then the ends are burned to prevent bleeding and promote healing. In the second, the tubes are simply cut and each end is tied to seal it closed. The third method involved no cutting of the tubes, but rather a small section is gathered and a tight band is placed around it to seal off any openings in the tube. (Nucleus Medical Media, Inc)
This image depicts the three different methods that could be used when performing a tubal ligation. The first is a cauterization in which the tubes are cut and then the ends are burned to prevent bleeding and promote healing. In the second, the tubes are simply cut and each end is tied to seal it closed. The third method involved no cutting of the tubes, but rather a small section is gathered and a tight band is placed around it to seal off any openings in the tube. (Nucleus Medical Media, Inc)

During a tubal ligation, a woman's fallopian tubes are either cut, tied, or blocked in order to prevent an egg from traveling from the woman’s ovaries to her uterus, as well as to prevent the sperm from traveling from the uterus through the fallopian tube where it would typically meet with an egg for fertilization, therefore preventing pregnancy. This procedure is commonly referred to as getting one's “tubes tied.” The procedure takes place while the patient is placed under general anesthesia where the doctor will go in and tie both fallopian tubes. However, upon waking up, the patient is able to finish their recovery at home.


Tubal ligation often involves one of two processes: a minilaparotomy, in which a small incision is made and fallopian tubes are pulled up for access, or a laparoscopy, in which a small device is inserted near the navel to view the reproductive organs, and another small incision is made where an instrument is inserted to perform the tubal ligation. After the procedure is complete and the patient has recovered, they can expect to continue to have regular menstrual cycles, periods, and sex.


Effectiveness

Tubal litigations are almost 100% effective, with less than 1% of women becoming pregnant after. However, upon the rare chance of a successful fertilization, there is a high chance an ectopic pregnancy will occur. This is when a fertilized egg gets implanted within the fallopian tube rather than the uterus. These types of pregnancies are not viable and must be terminated for the mother’s health.


While tubal ligations are seen as a permanent procedure, it is possible to reverse the surgery and “untie” one’s tubes. However, the possibility of fertilization and pregnancy is greatly reduced to a success rate of between 50%-80% according to John Hopkins Medicine.


Vasectomy


Procedure

This image provides a visual of the male reproductive system showing the continuation from the testes (which are contained within the scrotum) up through the vas deferens and out the urethra. Each vas deferens is cut and sealed in order to prevent sperm from incorporating into the male’s semen. (K.D. Schroeder/Wikimedia Commons)
This image provides a visual of the male reproductive system showing the continuation from the testes (which are contained within the scrotum) up through the vas deferens and out the urethra. Each vas deferens is cut and sealed in order to prevent sperm from incorporating into the male’s semen. (K.D. Schroeder/Wikimedia Commons)

During a vasectomy, the vas deferens are either cut, tied, or sealed to prevent sperm from traveling. The sperm, which are produced in the scrotum, then travel via the vas deferens to be incorporated into a male’s semen for ejaculation. Since these tubes are disrupted, the sperm is no longer able to leave the scrotum. Therefore, the semen no longer contains any sperm which would normally be present and lead to possible fertilization. Typically, the procedure involves a general anesthetic and one or two small incisions near the scrotum in which each vas deferens is pulled through. Doctors will then cut out a small section of each tube and tie the ends back together, sealing the connection with heat. A further blockage forms during recovery as scar tissue builds up. This procedure is permanent and therefore not reversible.


Effectiveness

When compared to female sterilization, vasectomies tend to be slightly more effective in preventing pregnancy. However, it typically takes around 2-4 months for a patient's semen to become sperm-free. Before that point, there is still a chance for fertilization, so couples should use alternative birth control methods or abstain from sexual intercourse to prevent an unwanted pregnancy. There are tests available to measure the sperm count within a male’s semen sample and confirm that none are present. Overall, there are very few risks involved with a vasectomy, and it is deemed an overall safer procedure than female sterilization. Some patients may experience minor bleeding or infection. However, there are no major risks involved in the procedure.


Sexually Transmitted Infections


While both female and male sterilization are very effective in preventing pregnancy, they do not prevent sexually transmitted infections and provide no barrier against contracting one.

Because of this, individuals should continue to use either a female or male condom in order to prevent the possible transmission of a sexually transmitted infection.


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