For most people who are not actively trying to grow their families, there is a good chance that birth control plays a role in their lives. Specific methods are more numerous than ever, but most couples still opt for the pill, according to the Centers for Disease Control and Prevention. It is not that there is anything wrong with this; The pill has come a long way in terms of safety and efficacy since it was approved for contraceptive use in 1960. Still, remembering to take this prescription every day is a major inconvenience for those who do not want to reproduce in the future. For these people, permanent birth control is often more attractive.
Before someone book a consultation appointment to eliminate their chances of procreating forever, you should become more familiar with the concept. Everything, from your age to the state of your relationship and your budget, matters when it comes to a permanent contraceptive method, and you do not want to end up in a situation where you feel you made a mistake. Before deciding to take the step, read.
Both men and women have options
Birth control often ends up being the responsibility of the woman, but there is no reason for this to be the case. She is clearly the one who would become pregnant, but her partner also plays a key role in the process. For this obvious reason, there are procedures for both men and women. The two most well-known types are tubal ligation (also known as tying the tubes) for women and a vasectomy for men.
We will start with tubal ligation since it is by far the most popular of the two. For this procedure, the surgeon makes two small cuts near the navel to access the fallopian tubes. According to MedlinePlus, the surgeon will cauterize the tubes or use a small band to close them. Once this happens, your ovaries can no longer release an egg in your uterus every month. In a slightly different type of procedure, surgeons will remove part or all of the fallopian tubes.
With a vasectomy, the idea is similar. The surgeon will make a small incision or puncture in the scrotum to access the vas deferens, which supplies sperm to a man’s semen. The surgeon will then cut the vas deferens and then cut or cauterize the ends. According to the Mayo Clinic, the entire procedure takes 10 to 30 minutes. For married couples or long-term partners, this is often the best option because, as explained by the Urological Care Foundation, it is only surpassed by abstinence from efficacy. But keep in mind that it is not immediately effective. According to The New York Times, it’s usually best to wait about six weeks.
Surgery is not the only way to go
In 2002, the FDA approved a product called Essure that blocks a woman’s fallopian tubes without the need for incisions. It may sound confusing, but Bedsider explains that the procedure is like a more complicated pelvic exam that uses local anesthesia. The doctor uses a very small catheter to pass through the cervix, which allows access to the fallopian tubes. He or she uses the catheter to insert the devices, which are essentially small metal coils, into the patient’s tubes. Over time, scar tissue accumulates around these coils to permanently block the fallopian tubes.
The main caveat to be taken into account with this procedure is that it takes time, usually about three months, for the tubes to be completely blocked. This means that women who choose the procedure will need to use an alternative method of contraception in the meantime. And it’s not smart to simply assume that everything worked after three months. The same article by Bedsider says it is critical to receive an x-ray or an MRI to confirm that everything went according to plan.
It could be reversible, but it might not be
While the idea of permanently avoiding an unwanted pregnancy might encourage people to sign up immediately, it’s not the kind of decision someone should take lightly. More and more people discover that they regret their decision and choose to reverse the change after changing their minds about parenting. While these procedures exist, they do not guarantee that you can have children. Johns Hopkins Medicine says that only 50% to 80% of women become pregnant after reversing tubal ligation.
As for those who choose Essure, it’s really hard to say. Because the treatment is very new, information on pregnancy rates after extraction is, at best, unstable. In vitro fertilization, however, remains an option.
Men tend to be more successful, but there is still no guarantee that they can have children. Part of this depends on the reversal method. According to a recent review, between 72% and 96% of men can expect to reopen the blockade. However, this still does not guarantee pregnancy. The same review reported pregnancy rates of 28% to 40%. It is perhaps more important to bear in mind that the studies mentioned have been relatively small. As far as we know, the chances of getting pregnant successfully could be significantly higher or lower.
There is no guarantee without pregnancy
Although rare, any form of permanent birth control carries some risk of pregnancy. Different studies suggest different pregnancy rates for the various procedures. The important thing to keep in mind is that there are always cases where women are unexpectedly waiting. The CDC reports that the risk of pregnancy is 0.15% with vasectomy and 0.5% for female sterilization.
There are risks
Any type of procedure carries some risk, so the sterilization is not different. For both men and women, there is the possibility of pain, hemorrhage and infection. With vasectomies in particular, the University of Washington School of Medicine says that some men experience chronic pain after the procedure. The story also mentions that some studies have linked the procedure to an increased risk of prostate cancer, but it is still too early to say for sure.
Essure is a slightly different story. Dozens of women have filed complaints of pain and serious health complications after undergoing the procedure. In 2018, the FDA restricted the sale of the product.
More options are on the horizon
Although a vasectomy is currently the only option for men, this may change in the coming years. Researchers have been testing an injection called Vasalgel for years, and the results are still promising. It is essentially a gel, which a doctor injects into the vas deferens of a man, which allows the passage of fluids but not the sperm. Another advantage? It is potentially easier to reverse. You can read more about this at Parsemus Foundation, a nonprofit organization that works to bring the product to market.
A study published in Basic and Clinical Andrology found that Vasalgel is almost 100% effective when tested in rabbits. However, before you overflow too much, it is still important to look at the details. To begin with, this was an animal study. The sample size was also quite small, only 12 rabbits. There is still more evidence to be done, but it is programmed to move forward.