Family Health Guide

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Birth Control: Permanent Procedures

Both men and women can undergo measures to render them infertile. It sounds scary - you put time, effort, and a substantial amount of sex into getting pregnant - but it's the most used form of birth control for couples in their 30s and 40s who have completed their families. If you or your partner is considering undergoing a procedure, you need to be certain that your biological family is complete and consider future life changes such as divorce and remarriage.

For the man, a vasectomy works by blocking the van deferens tubes that carry sperm from the testes to the penis and prevents release of sperm. The vasectomy is a simpler procedure and has fewer risks than what a woman must undergo. It's 99% effective at preventing pregnancy.

There are two methods of vasectomy: The vans deferens tubes are tied, cut, clipped, or sealed through one or two small cuts in the skin of the scrotum. Or it can be performed without an incision using a tool to puncture the scrotum and get to the vans deferens and tie them off. Both of these procedures are out patient and may be done in a doctor's office, clinic, or hospital and a man still has the ability to have an erection and ejaculate. It can takes up to 3 months for the vasectomy to work because sperm may be left in tubes so another method of birth control needs to be used. Your partner will need to get a semen analysis to verify sex is "safe".

The usual complications of surgery and general anesthesia are possible side effects. While it's sometimes possible to reverse a vasectomy, there are no guarantees. It's both complicated and pricey, and depends on how long ago the procedure was performed and what method was used.

For women, tubal sterilization  - surgically blocking or cutting the fallopian tubes - prevents eggs from entering the uterus to be fertilized but does not affect getting your period. Tubal sterilization is 99% effective at preventing pregnancy.

There are three methods: Surgery is performed via laparoscopy or minilaparotomy. This requires a small cut in your abdomen so the fallopian tubes can be closed by tying, banding, clipping, blocking, or cutting them, or by sealing them with electric current. A hospital stay is not required.

It's also something you can do immediately postpartum. It’s performed at the same time as a C-section and has the usual complications of surgery and general anesthesia as possible side effects. It's also possible to have it done after a vaginal delivery, using the epidural as anesthesia, meaning the risks involved only concern ones that could arise from the epidural. A small incision is made under the bellybutton and there is no added recovery time or hospital stay.

For the third and non-surgical method, a hysteroscope is placed through the cervix into the uterus and a tiny device is inserted into each fallopian tube. There are two options: Essure is like a tiny spring, while a new option, Adiana, uses a silicone device. Both causes scar tissue to build up, block the fallopian tubes and prevent the sperm from reaching the egg. They are 98% effective at preventing pregnancy.

The procedure takes about 10 minutes and then 3 months for the scar tissue to grow and seal tubes, so a back up method will be needed. Female sterilization cannot be reversed.