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Home — Health Professionals — How to Choose the Right Contraceptive Method — How They Work; Pros and Cons — Permanent Sterilization

How to Choose the Right Contraceptive Method

How They Work; Pros and Cons

Permanent Sterilization

Mechanism of Action-	Occlusion of the ducts (fallopian tubes or vas deferens) to prevent the ovum and the spermatozoa from meeting.
Dosage-	The tubal ligation is effective immediately following surgery. The vasectomy requires confirmation of absence of motile sperm in the semen sample 6 weeks to 3 months following surgery.
Advantages-	Private and cost effective method of contraception. No long term side effects. No adherence issues. No interference with intercourse. Highly effective. Day procedure involving minimal time off work.
Disadvantages/Side Effects-	Permanent method of contraception with the potential for regret following the procedure. Complications may arise from surgery particularly following a tubal ligation as this procedure usually involves a general anaesthetic and is more invasive than a vasectomy. Irreversible in most cases.
Efficacy-	The Pearl index is 0.2-0.6 (failure rate for 100 women using this method for one year). However pregnancy may occur years after tubal occlusion due to fistula formation. These are more likely to result in ectopic pregnancies.
Contraindications/Poor candidates-	Women or men who have any doubts about future desire for childbearing. Local genital disorders impairing adequate localization of the vas deferens. If the man is particularly anxious about his virility or already has a sexual dysfunction. The inability to gain access to the fallopian tubes at surgery because of previous pelvic infection or pelvic adhesions. Systemic health problems that may be aggravated by surgery. This is rarely an issue for men undergoing a vasectomy because the procedure is performed under local anaesthesia.
Follow-up	A semen analysis is required 6 weeks to 3 months following a vasectomy to ensure no further motile sperm are present. No follow-up is required after a tubal ligation. Should pregnancy be suspected in a woman following tubal occlusion, investigation to rule out an ectopic pregnancy may be warranted.

Last Modified: November 6, 2007