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Tubal sterilization: focus on the U.S. experience
1Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, New York, USA. clw3@columbia.edu
Fertility and Sterility
|April 28, 2000
Summary
Bilateral tubal sterilization (TS) is a highly effective and safe contraceptive method for millions of women. While uncommon, failure rates are higher than previously thought, and TS is linked to a reduced risk of ovarian cancer.
Area of Science:
- Reproductive Health
- Gynecology
- Contraception
Background:
- Tubal sterilization is a widely used permanent contraception method in the U.S.
- Approximately 700,000 procedures are performed annually, with half occurring postpartum.
- Over 11 million U.S. women aged 15-44 rely on this method.
Purpose of the Study:
- To review the incidence, efficacy, and clinical outcomes of tubal sterilization.
- To focus on the U.S. experience with tubal sterilization.
Main Methods:
- A comprehensive review of U.S. health care statistics.
- Analysis of English-language literature identified through MEDLINE searches, key reference bibliographies, and U.S. government publications.
Main Results:
- Failure rates vary by method, with over one-third of failures resulting in ectopic pregnancy.
- Reversal success is highest with methods that preserve more of the fallopian tube.
- Evidence for menstrual or hormonal disturbances is weak, but some studies suggest higher hysterectomy rates among sterilized women.
- A decreased risk of subsequent ovarian cancer has been observed.
Conclusions:
- Tubal sterilization is a highly effective and safe contraceptive option.
- Failure rates, though infrequent, are higher than previously recognized.
- There is limited evidence for significant hormonal or menstrual changes post-sterilization.
- Tubal sterilization is associated with a reduced risk of ovarian cancer.