Sterilization as permanent birth control. Part 3

Posted On: Wednesday, October 31st, 2012 at 1:27 pm

Sterilization may have a slight protective effect for ovarian cancer and pelvic inflammatory disease. A study that monitored some 77,000 women for 12 years found a reduced rate of ovarian cancer in women who had had tubal occlusion or hysterectomy.

How often does sterilization fail?

Vasectomy — The failure rate is less than 1 percent. Most failures are due to having unprotected sex too soon after the procedure. It takes about 3 months or 20 ejaculations to flush all viable sperm from the system and your semen must be tested to determine when that has occurred. Failure may also be due to the unlikely occurrence of spontaneous rejoining of the vas deferens or from failure to cut the correct structures in the scrotum.

Tubal ligation — While the failure rate for tubal ligation was long thought to be about the same as vasectomy, a recent Centers for Disease Control and Prevention (CDC) study indicated that over a 10-year period, the failure rate was slightly higher (about 2 percent) and that the risks of ectopic pregnancy are greater for women with tubal ligation. This is a concern because ectopic pregnancy (in which an embryo implants and develops outside the uterus) can be life-threatening. The risk is highest for women who are sterilized before age 30 or whose sterilization was with bipolar coagulation in which electric current cauterizes (burns) the tubes.

Does sterilization affect sexual desire or function?

Vasectomy — Sexual function and desire are not affected. The ability to achieve and maintain erections and have orgasms with ejaculation is unchanged.

Tubal ligation — Sexual function and desire are not affected. In fact, both men and women frequently report increased pleasure because they are no longer worried about unwanted pregnancy.
How expensive is sterilization?

Vasectomy — The cost may range from $250 to $1,000.

Tubal ligation — The cost may range from $1,000 to $2,500.
Can the procedures be reversed?

Vasectomy — Should be considered permanent. Surgical reversal of a vasectomy is possible, but the outcome is very uncertain and expensive.

Tubal ligation — Should be considered permanent, but may be reversed. An attempt at reversal involves major surgery with about a 70 percent success rate.

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