Male and Female Sterilization

Sterilization is the only permanent method of contraception for men and women. Male sterilization is done by performing a vasectomy, and female sterilization involves undergoing a tubectomy.

In vasectomy, the tubes called vas deferens of the male reproductive system are cut or blocked to prevent the sperm from being carried from the testicles to the urethra. It is one of the most effective methods of birth control but pregnancy can occur in 1 out of every 2000 vasectomies performed.

A tubectomy, also called tubal ligation, is a surgical procedure where the fallopian tubes of the female reproductive system are cut and tied or clipped using rings/clips. This prevents the fertilization of the egg by the sperm. It is the most effective method of birth control. Pregnancy can occur in 2 out of 1000 individuals who undergo tubectomy.

Who can undergo sterilization?

Anyone above the age of 18 years can undergo sterilization, but it is advised that individuals should speak with their doctor before deciding to undergo this. One should only consider this option if they are certain that they do not want anymore or any kids.

Even though, technically, it is reversible, but it does not always work. The surgery from reversal is more complicated than sterilization.

The Procedure

Vasectomy

It is performed under local anaesthesia. It may be performed under general anaesthesia, in some rare cases. There are 2 ways to perform vasectomy –

• Conventional vasectomy: Small cuts are made in the scrotum to reach the vas deferens tubes. A small piece of the tube is removed, leaving a small space between the two ends. Then, the two ends may be tied together, or some tissue put in between them. The small cuts in the scrotum may be surtured together with dissolvable stitches or allowed to heal on their own.
• No-scalpel vasectomy:  The surgeon feels for the vas deferens tube and holds it in place with a clamp. A tiny hole is then made in the scrotum so the tube can be taken out and then cut or tied. Afterward, the vas deferens tube is put back in place.

It is not effective immediately. It takes up to 12 weeks for the sperm in the tubes to be cleared. One should wait for two negative semen samples for sperm before relying on vasectomy as a method of contraception.

Tubectomy

The surgeon accesses the fallopian tubes by making a small cut near the belly button (laparoscopy) or above the pubic hairline (a mini-laparotomy). A laparoscope consisting of a light and camera is inserted into the tubes, and they are blocked by applying clips or rings, or by tying, cutting, and removing a small piece of the tube.

Vasectomy versus tubectomy

A vasectomy takes up to 12 weeks after the procedure to be effective. Tubal ligation, on the other hand, is effective immediately. It is considered to be more effective than tubectomy after a year.

Both forms of sterilization fail to prevent STDs.

Couples may choose to opt for a vasectomy as it is:

• Typically, more affordable
• Less invasive and comparatively safer
• Does not raise the risk of ectopic pregnancy

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