Abstract

PIP: 95 million worldwide have undergone sterilization, 6 million of the in the US, and on the North American continent 800,000 sterilizations are performed annually. Since 1972, sterilization has been available liberally in Czechoslovakia. 85% of women bear 2 children by age 30, and more than 40% of abortions are repeat abortions, a large percentage of them for women 30. Microsurgery can restore fertility in 50-70% of cases. The negative effect of tubal sterilization on the menstrual cycle was studied in a caseload of 52,026 operations at 45 institutes in 24 countries. 1555 women aged 25-34 with a parity of 2-6 children were selected, and they were followed up for 3 cycles prior and 3 cycles after sterilization. 82% claimed regular menstruation, 54% had irregularity, in 8% irregularity changed after the operation, and in 5% the regular cycle became irregular. In 26%, the days of bleeding decreased, and they increased in 22%. In 2 groups of 86 women each who underwent tubal ligation and hysterectomy in the course of Cesarean section, postoperative infection was 9.3% with hysterectomy and 19.7% with tubal ligation. The negative effect of tubal sterilization on ovarian steroid genesis was shown in 112 women under age 46 with regular menstruation 2 years subsequently: urogenital, cardiovascular, and psychological disorders occurred. In a group of 59 women 41 and another group of 59 women aged 20-41, a significant drop of total estrogen excretion was found 24 hours after sterilization. In another 14 cases, depression and chronic mastopathy developed 2 years after the procedure, necessitating bilateral mastectomy; 3 years later osteoporosis occurred; 4 years later hemotological dysfunction ensued, and another 2 years later angina pectoris developed. In another 15 women, postoperational hypoestrinism was demonstrated after breast carcinoma surgery. A comparative study of 1107 sterilized women and 530 controls showed no change in the regularity or intensity of menstruation; however, dysmenorrhea increased: 10.8% in the sterilized caseload vs. 2.1% in controls. According to some studies, the restoration of fertility was possible in 80% of cases.