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Birth Control Methods01:22

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Vasectomy is a surgical form of male sterilization that involves severing and sealing the vasa deferentia, preventing sperm from mixing with semen during ejaculation. Because a vasectomy does not impact the testes' ability to produce testosterone, hormone levels, libido, and sexual function generally remain unchanged. While vasectomy is highly effective in preventing pregnancy, with a success rate near 99.85%, rare cases of recanalization (spontaneous reconnection) can occur. Although vasectomy...
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Postpartum sterilization with the titanium clip: a systematic review.

Maria I Rodriguez1, Alison B Edelman, Nathalie Kapp

  • 1From the World Health Organization, Department of Reproductive Health and Research, Geneva, Switzerland; and the Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon.

Obstetrics and Gynecology
|June 22, 2011
PubMed
Summary

The titanium clip shows decreased efficacy for postpartum sterilization compared to partial salpingectomy, with a higher pregnancy risk. Routine use is not recommended due to limited evidence.

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Area of Science:

  • Reproductive Health
  • Surgical Sterilization
  • Gynecology

Background:

  • Postpartum sterilization is a common method for permanent contraception.
  • Various methods exist, including surgical procedures and device-based applications.
  • Assessing the long-term efficacy of different sterilization techniques is crucial for patient counseling.

Purpose of the Study:

  • To evaluate the effectiveness of the titanium clip for postpartum sterilization.
  • To compare the pregnancy risk associated with titanium clip sterilization versus other methods.

Main Methods:

  • Systematic review of Medline and Cochrane databases up to January 2011.
  • Inclusion of 13 articles: 10 observational trials and 1 randomized controlled trial.
  • Exclusion of studies on Hulka clips or postabortion sterilization.

Main Results:

  • The only randomized controlled trial indicated a significantly higher pregnancy risk at 24 months with titanium clip sterilization (1.7%) compared to partial salpingectomy (0.04%).
  • Data abstraction and quality assessment were performed systematically.
  • Evidence quality was rated using the U.S. Preventive Task Force System.

Conclusions:

  • The titanium clip demonstrates lower efficacy than partial salpingectomy in postpartum sterilization.
  • Routine recommendation for titanium clip use in the postpartum period is not supported by current evidence.
  • Further research may be needed to fully ascertain the long-term outcomes.