Sterilization

How does sterilization work?

For female sterilization, the fallopian tubes are cut which prevents the egg from reaching the uterus. For male sterilization, the vas deferens are cut, which prevents the sperm from joining the semen; accordingly the ejaculated semen is free of sperm.

When can a woman have a female sterilization?

If a woman recently delivered, it can be done within the first 7 days from delivery (only by mini-laparotomy procedure) or anytime after 40 days.
If the delivery is done through a caesarian section (C/S), the procedure can be done at the time of the C/S.
Any time a woman is certain she is not pregnant.
Within 48 hours of abortion or miscarriage or any time 40 days thereafter.

When can a man have a vasectomy?

Any time he wishes.

How is female sterilization performed?

Female sterilization is a surgical procedure and should be done in a hospital by a trained obstetric and gynecology specialist. It can be done under local or general anesthesia by mini-laparotomy, laparoscopy, or during a C/S; the fallopian tubes are reached and tied, clipped or ligated. After the procedure, the woman usually stays at the health facility for several hours or a few days, depending on the type of operation and her situation. Usually laparoscopy clients can leave within a few hours. The woman needs to rest and take care of the incision for several days and return for a follow-up visit one week after the procedure or as requested by her physician.

How is male sterilization performed?

Male sterilization as a minor surgical procedure and should be done by a trained physician. The procedure can be done in physician’s clinic, under local anesthesia. Small incisions are made to the scrotal skin to reach the vas deferens and occlude them. The skin is then closed with or sometimes without sutures. After the procedure, the man needs to stay about an hour at the health center for observation before going home. He should return for a follow-up visit 3 months after the procedure to do a sperm analysis test to assure that the semen is free from sperms.

How long does it take for sterilization to take effect?

Female sterilization is effective immediately after the procedure, while for male sterilization 20 ejaculations or a period of 3 months (which ever comes first) is generally advised.

Are there side effects associated with sterilization?

Sterilization may cause discomfort and pain during and after the procedure, but in most cases there disappear shortly after If a man or woman experiences any of the following warning signs s/he should seek immediate health care:

Severe pain, heat or tenderness, pus or bleeding from the incision.

Lower abdominal pain (for female sterilization).

Abnormal or unusual vaginal bleeding (for female sterilization).

Can the sterilization procedure be reversed?

Sterilization should be considered a permanent method, therefore individuals must be 100% certain that both do not want anymore children. Sterilization can be reversed by a surgical procedure to re-tie the fallopian tubes for woman or the vas deferencs for the male, however, the success rate of reversal operations is very low and requires a highly trained physician. Therefore, it is not recommended to undergo sterilization if a person has any doubts about future fertility.

How does sterilization differ from other contraceptives?

Sterilization is a permanent method and a woman will not be able to have more children after the procedure unless it is reversed surgically.

Will female sterilization change a woman's menstrual cycle or make menstrual bleeding stop?

No. Most studies find that no major changes in bleeding patterns occur after female sterilization. However, menstrual bleeding might change if the woman was using an IUD or other hormonal method prior to the procedure. Also, woman's menstrual period usually become less regular as she gets older.

Will sterilization make a woman or a man lose sexual ability, desire or pleasure?

No, neither female nor male sterilization decreases sexual ability at all. On the contrary, a couples sexual ability might increase as they may no longer be concerned about having an unwanted pregnancy.

What are the main things a couple needs to know before deciding to use sterilization?

Couples should make an informed choice about sterilization and should know the following:

- Temporary contraception methods exist.
- Voluntary sterilization is a surgical procedure.
- There are certain risks involved with any surgical procedure.
- If the operation is successful, pregnancy cannot occur.
- The procedure is considered permanent and can only be reversed through another surgical procedure.
- A couple can decide against the procedure at any time before it takes place without losing rights to other health services.
- Reversibility of procedure is difficult, expensive, requires special experts, and chances of success are low.

Is it better for a man to have a vasectomy or for a woman to have tubal ligation?

Couples should decide for themselves which method is better for them. Both methods are highly effective and permanent. Vasectomy is simpler and much safer than female sterilization as it is done under local anesthesia and the man can usually leave the clinic within an hour after the procedure. Also, vasectomy is usually less expensive than female sterilization as it can be done in a clinic whereas female sterilization is performed in a hospital.