Female Sterilization 

Surgical sterilization is either ligation or microfilament placement in the tubal region. Bilateral tubal ligation can be performed postpartum through a small intraumbilical incision or a laparoscope. A modern alternative to interval tubal occlusion involves the use of hysteroscopic transcervical microfilament placement. About 10.7 million women in the United States rely on sterilization. The failure rate for 1,000 procedures over 10 years is 18.5 pregnancies.

Surgical sterilization is permanent, effective, and has no side effects. The mortality rate of the procedure is 1-2/100,000. The risk of ectopic pregnancy is elevated at 33%, a notable increase compared to the 1.5% risk seen in the general population.

Regret occurs more often for younger patients or during postpartum when the patient’s life situation changes. Tubal reversals are only successful in 43-80% of cases and are expensive. If a patient wishes to conceive after tubal ligation, in vitro fertilization is a successful option but can be very expensive.

Male Sterilization 

Surgical sterilization in men is accomplished through a procedure known as vasectomy. Vasectomy is recognized for its superior safety, cost-effectiveness, and efficacy when compared to female sterilization. In the United States, approximately 4.2 million men opt for vasectomy as their sterilization method of choice. The one-year failure rate for vasectomy stands impressively low at 0.15%, in contrast to the 0.5% failure rate associated with female sterilization. Additionally, male sterilization costs roughly one-third of the expenses incurred with bilateral tubal ligation. Vasectomies are routinely performed in an office setting under local anesthesia. To confirm the success of the procedure, two negative semen analyses are typically required.