Last updated January 13, 2022

Benefits and Risks of Sterilization

Recommendations and Conclusions

The following recommendations and conclusions are based on good and consistent scientific evidence.

  • Tubal occlusion by laparoscopy is a safe and effective method of permanent contraception.
  • Tubal occlusion does not protect against sexually transmitted infections (including HIV).
  • Compared with abdominal approaches to female sterilization, vasectomy is safer, more effective, and less expensive.
  • Laparoscopic tubal occlusion is far more effective than short-term, user-dependent, reversible contraceptive methods, such as oral contraceptive pills, injections, and barrier methods.
  • Long-acting methods of contraception, including IUDs and the contraceptive implant, are at least as effective as tubal occlusion and are associated with lower morbidity and mortality.
  • Although pregnancy after a sterilization procedure is uncommon, there is substantial risk that any post- sterilization pregnancy will be ectopic.
  • Patients who have undergone sterilization procedures have a lower ectopic risk than non-contraceptive users.
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The following recommendations are based on limited or inconsistent scientific evidence.

  • Postpartum partial salpingectomy is associated with lower failure rates than interval tubal occlusions done by laparoscopy.
  • Laparoscopic tubal occlusion reduces the incidence of ovarian cancer.
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The following recommendation is based primarily on consensus and expert opinion.

Women should be counseled about the risk of failure, risk of regret, and alternatives (including LARC and vasectomy). In a well-informed woman, age and parity should not be a barrier to sterilization.
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Recommendation Grading

Overview

Title

Benefits and Risks of Sterilization

Authoring Organization

Publication Month/Year

March 1, 2019

Document Type

Consensus

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Female, Adult

Health Care Settings

Ambulatory, Operating and recovery room, Outpatient

Intended Users

Physician, nurse nurse midwife, nurse certified nurse midwife

Scope

Counseling, Management

Diseases/Conditions (MeSH)

D013246 - Sterilization, Tubal, D014659 - Vasectomy, D013242 - Sterilization

Keywords

Sterilization, vasectomy, contraception, permanent contraception, tubal occlusions