Sterilization is a procedure or intervention that prevents a woman from getting pregnant or makes a man incapable of fathering a child. It is generally accomplished through a minor surgical procedure.
In men,
Sterilization is achieved with an operation called a vasectomy, in which the vas deferens, the tube that connects the testicle to the urethra, is cut. The man continues to produce sperm, but the
sperm no longer reach the semen. A man is not immediately sterile after a vasectomy; several ejaculations are required to clear all the sperm from the system. Follow-up semen analysis is usually performed before declaring sterilization complete. A
vasectomy is usually performed with a local anesthetic on an outpatient basis.
In women, sterilization is usually accomplished through a procedure known as
tubal ligation, in which the fallopian
tubes are tied, cut, or banded using a variety of techniques, or the tubes are totally removed. This operation can be performed directly through a small incision in the abdomen or by laparoscopy (see laparoscopic surgery). A tubal
ligation is not outpatient
surgery and requires more complex surgical equipment and a major anesthetic. A woman is considered sterile immediately after tubal ligation. Sterilization also results from removal of the uterus (hysterectomy) or ovaries (oophorectomy), but these procedures are considered major surgery and are usually performed for other health reasons.
Sterilization methods can fail. Pregnancy can occur in women who have had a tubal ligation, and children can be fathered by men who have had a vasectomy. For example, approximately one of every 400 men or women develops a fistula, a tract through which the sperm or egg can travel. However, procedures have been developed to minimize this risk.
Sterilization was once considered irreversible, but procedures have been developed to reunite divided fallopian tubes or vas deferens. Microsurgery is one of the more successful techniques, with about 80% of patients able to get pregnant.
Sterilization techniques such as injection with various substances to block the fallopian tubes or the vas deferens have not had consistent success. Permanent infertility can also occur as a side effect of treatments such as radiation therapy or chemotherapy.
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