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For further information, see CMDT Part 18-12: Contraception
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In the United States, sterilization is the most popular method of birth control for couples who want no more children
Vasectomy is a safe, simple procedure in which the vas deferens is severed and sealed through a scrotal incision under local anesthesia
Female sterilization is performed via
Laparoscopic bipolar electrocoagulation
Salpingectomy
Plastic ring application on the uterine tubes
Minilaparotomy with tubal resection
Hysteroscopic transcervical sterilization
The cumulative 10-year failure rate for all methods combined is 1.85%, varying from 0.75% for postpartum partial salpingectomy and laparoscopic unipolar coagulation to 3.65% for spring clips
Two methods of transcervical sterilization, Essure and Adiana, can be performed as outpatient procedures
Essure
Involves the placement of an expanding microcoil of titanium into the proximal uterine tube under hysteroscopic guidance
Efficacy rate at 1 year is 99.8%
Should have tubal occlusion confirmed at 3 months with a hysterosalpingogram
As of 2018, Essure was no longer marketed due to concerns related to complications and side effects reported by users