Sterilization in the United States

Abstract

Unintended pregnancies are expensive for patients and for society in terms of medical costs, the cost of caring for more children, and the cost to personal and professional goals. Sterilization is the most common contraceptive method utilized by couples in the United States. Given technological advances over the past few decades, male and female surgical sterilization has become a safe, convenient, easy, and highly effective birth control method for the long term. This article reviews current male and female sterilization options.

Keywords: Sterilization; Transcervical tubal occlusion; Tubal ligation; Vasectomy.

Figure 1

Tubal ligation techniques. Reprinted with permission from Hatcher RA et al.

Figure 2

The Essure (Conceptus, Inc., Mountain View, CA) procedure for permanent birth control. Copyright 2006 Conceptus Incorporated. All rights reserved.

Figure 3

Tubal occlusion is confirmed 12 weeks following Essure (Conceptus, Inc., Mountain View, CA) microinsert placement by hysterosalpingogram. Copyright Conceptus Incorporated. All rights reserved.

Figure 4

Efficacy of tubal ligation in the 10 years following the procedure. However, effectiveness varies with the ligation method employed. Data from Peterson HB et al.

Figure 5

According to the Collaborative Review of Sterilization (CREST) study, the cumulative probability of expressing regret following tubal sterilization was 12.7% (95% CI, 11.2–14.3). Several patient characteristics have been determined to be predictors of regret: young age at the time of sterilization, sterilization postpartum, divorce and/or remarriage subsequent to sterilization, being poor (eg, Medicaid patients), and being of Hispanic origin. Reprinted from Fertility and Sterility, Volume 74, Schmidt JE et al, “Requesting information about and obtaining reversal after tubal sterilization: findings from the U.S. Collaborative Review of Sterilization,” pp. 892–898, Copyright 2000, with permission from Elsevier.