Sterilisation procedures are permanent surgical interventions to prevent conception. It is essential to thoroughly counsel patients about the permanence of the procedure, and ensure they have made a fully informed decision. Sterilisation does not protect against sexually transmitted infections.
The NHS does not provide reversal procedures. Private reversal procedures are available, but the success rate is low. Therefore, sterilisation should be considered permanent.
Tubal Occlusion
The female sterilisation procedure is called tubal occlusion. This is typically performed by laparoscopy under general anaesthesia, with occlusion of the tubes using “Filshie clips”. Alternatively, the fallopian types can be tied and cut, or removed altogether. This can be done as an elective procedure, or during a caesarean section.
The procedure works by preventing the ovum (egg) travelling from the ovary to the uterus along the fallopian tube. This means the ovum and sperm will not meet, and pregnancy cannot occur.
The procedure is more than 99% effective (1 in 200 failure rate). Alternative contraception is required until the next menstrual period, as an ovum may have already reached the uterus during that cycle, ready for fertilisation.
Vasectomy
The male sterilisation procedure is called a vasectomy. This involves cutting the vas deferens, preventing sperm travelling from the testes to join the ejaculated fluid. This prevents sperm from being released into the vagina, preventing pregnancy. It is more than 99% effective (1 in 2000 failure rate).
The procedure is performed under local anaesthetic and is relatively quick (15 – 20 minutes). This makes it a less invasive procedure than female sterilisation and often a better option for couples that are considering permanent means of contraception.
Alternative contraception is required for two months after the procedure. Testing of the semen to confirm the absence of sperm is necessary before it can be relied upon for contraception. Semen testing is usually carried out around 12 weeks after the procedure, as it takes time for sperm that are still in the tubes to be cleared. A second semen analysis may be required for confirmation.
Last updated August 2020