Contraception, Sterilization

Key Features

• 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