Sterilization in Women
Dr. Maria Zweig MD
Sterilization is a permanent method of avoiding pregnancy. In humans it is known as a vasectomy where the woman’s fallopian tubes are tied, cut or removed. No matter which option you choose all are permanent. We try to emphasize the fact that it is supposed to be a permanent procedure because we have received countless inquiries about reversing sterilization. Unfortunately, most of these inquiries have been from patients that were misinformed by there doctors, and were under the assumption that reversing the procedure would be relatively easy and it wouldn’t be costly. This could not be further from the truth.
When discussing sterilization reversal it is referred to complicated surgeries costing thousands of dollars or considering In-Vitro Fertilization with costs thousands more still. Regardless neither options ensure a successful pregnancy.
Sterilization is a major life decision, it is a decision that means that neither you nor your partner wants to become pregnant in the future. It is a personal decision that one should not feel into by a physician, partner or family. Keep in mind that there are alternatives lasting up to 10 years which are as safe as sterilization and reversible. The decision for permanent sterilization can always be decided later.
How successful is sterilization in women?
About 5 in 1,000 women who have been sterilized will continue being so after one year. If pregnancy does occurs after a sterilization procedure it will most likely be an ectopic pregnancy.
What advantages do sterilizations have?
It is permanent, you will not need contraceptives in the future. It is a relatively inexpensive. It should not have an impact on your health, ruling out surgical risks. It should not alter the hormonal state of the woman or her periods.
Are there disadvantages to sterilization?
It is permanent, the most common feedback from my patients is regret for having been sterilized. With all the twists and turns of life, I prefer my patients choose a method of long-lasting but reversible contraception, such as an Intra Uterine Device. There are some that lasts 10 years and others five years and all have similar sterilization without the need for anesthesia or visits to the operating room.
Additional factors leading to regret for this decision are very young age (under 30 years) when committing to the operation. As such sometimes they change partner or there is a death of a child.
Likewise, sterilization is a surgical procedure which entails all the risks and discomforts involved such as the risk of anesthesia, infection, bleeding and post-operative pain.
Sterilization does not prevent sexually transmitted diseases.
What are the methods of sterilization?
There are two routes– vaginal or abdominal.
- Abdominal may be through the navel, a laparoscopy under general anesthesia or the day after a vaginal delivery with a small incision at the navel.
- Alternatively to this is to make an incision in the lower abdomen below the pubic hair, a mini -laparotomy, which may be done under general or spinal anesthesia (regional).
- Via the vaginal route hysteroscopic sterilization, a “slinky’s” (Essure) is placed to obliterate the fallopian tubes. Sedation, regional or general anesthesia can be used.
- Some women also take advantage at the time of Cesarean surgeries to go ahead and have a sterilization also performed.
How is a sterilization procedure performed?
Sterilization interrupts the process of fertilization. It cuts, obliterates, or removes part or all of the fallopian tube which complicates the pathway for sperm to fertilize the ovum. The doctor usually chooses, based on specifics about the patient, as well as patient preference and desire for anesthesia.
When is a good time to be sterilized?
Sterilization can be done at any point during the menstrual cycle however, it is ideal to be performed closely following a menstrual period. It can also be done the day after vaginal birth or during a Cesarean.