The Sterilization Decision-Vasectomy vs. Tubal Ligation

You have had all the children you would like and you like to ensure that you won’t have another pregnancy then you need to make the sterilization decision.

So who is going to become sterilized? This him-or-her question should be decided with great care. For couples weighing whether they’re ready to permanently prevent pregnancy, here are some important questions to ask.

At this time men have just one option when they want to permanently turn off the possibility of sperm getting to an egg– and women can choose from several. For men, the option is a vasectomy. A doctor cuts and seals off the two tubes that allow sperm to travel from the testicles to the outside world.

The vasectomy can be done without a scalpel and without a needle to inject the local anesthetic so it is nearly painless. The procedure takes about 10-12 minutes but the man is not sterile right away. He needs to ejaculate approximately 15 times to purge sperm from the vas above the area where the occlusion of vas takes place. (See Figure)

After 15 ejaculations, a specimen must be examined under a microscopic to be absolutely certain that there is no sperm in the ejaculate and then the man is sterile.
Women can have a tubal ligation, also called a “tubal” or “getting your tubes tied.” Her fallopian tubes are sealed off, keeping her eggs from meeting any sperm. Or a doctor can do an in-office procedure in which he inserts tiny devices into the tubes through the uterus, blocking them permanently.
Women become sterilized nearly three times as often as men. About 16% of reproductive-age women had opted for tubal sterilization in 2002, compared to 6% of the male member of the relationship who submits to a vasectomy.

What Could Go Wrong?
Women were 20 times more likely to have a serious problem related to a tubal than men face from a vasectomy. In addition, men tend to recover more quickly from a vasectomy than women do from a tubal ligation. A tubal ligation requires anesthesia and deep incisions into her abdomen both of which are concerns.
The most common problems related to vasectomy include bruising, infection, and inflammation in the epididymis, a sperm-holding structure near the testicle. But each of these seems to occur in less than 5% of cases.

How Much Does It Cost?
In terms of cost, a vasectomy is definitely more cost-effective. In general, a tubal costs about three times as much as vasectomy.
If you have health insurance, check on whether it will cover the procedure and what costs may still be your responsibility. Talk with your health care provider to see what your costs are for other birth control options, since other forms of birth control may be more cost-effective.
Bottom Line: There are effective methods of sterilization. A discussion with your doctor will help you decide which one is right for you, vasectomy or tubal ligation.

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