Sterilisation

• 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. 

  The NHS does not offer reversal procedures
• Female sterilisation:

  • Tubal occlusion - using Filshie clips
  • Typically performed by laparoscopy under general anaesthesia
  • Alternatively the fallopian tubes can be tied, cut or removed (salpingectomy)
  • Can be elective or during caesarean section
  • More than 99% effective
  • Alternative contraception is required until the next menstrual period - ovum may have already reached the uterus
• Vasectomy:

  • Cutting the vas deferens - preventing sperm travelling from the testes to join the ejaculated fluid
  • More than 99% effective - more so than female sterilisation
  • Performed under local anaesthetic and quick
  • Alternative contraception required for 2 months after procedure
  • Semen testing usually carried out around 12 weeks after - takes time for sperm that are still in the tubes to be cleared
• Female sterilisation limitations:

  • Carries risks of surgery, including bleeding, infection and pain
  • Very difficult to reverse (considered irreversible)
  • Individuals need to be informed that, in rare cases, they can still become pregnant
  • If pregnancy occurs, more likely to be an ectopic pregnancy
  • Does not protect from STIs
• Vasectomy limitations:

  • Carries risks of surgery, including bleeding and infection
  • Some men experience pain after their surgery (post-vasectomy pain)
  • Very difficult to reverse
  • Contraception should be used afterwards until semen is confirmed to be sperm-free
  • Does not protect from STIs