Permanent contraception entails inhibiting a person’s ability to reproduce. This can be referred to as sterilization

The capacity to reproduce is disrupted when the tubes that transport sperm or egg are impaired.

Always think of this kind of birth control as permanent.

Even though a vasectomy for men and a tubal ligation (tying of the tubes) for women can sometimes be undone, the surgery is much more complicated than the first one and may not work, and usually very much unsuccessful, especially in men.

So, before you choose permanent contraception, you should be sure you don’t want to get pregnant or impregnant a woman again.

Permanent Contraception In Men

Vasectomy:

Vasectomy is the most common way for men to achieve permanent contraception by surgery. It involves making a small cut in the scrotal sac, cutting or burning the vas deferens (the tubes that carry sperm), and then closing up both ends of the cut tubes. 

Most of the time, the procedure is done in an outpatient setting with only local anesthesia. By blocking the vas deferens, a vasectomy stops sperm from getting into the seminal fluid. Each year, more than 200,000 men in the US get their tubes cut.

Some men may get bruises in their testicles after having a vasectomy. Some sperm may still be in the vas deferens for a few months after the procedure, so a man is not considered sterile until he has ejaculated without any sperm. A lab test is done a few weeks after the procedure to see if the sperm is gone from the sperm. 

Most of the time, this takes 15 to 20 ejaculations. (The couple should use something else to prevent pregnancy during this time, or the man could ejaculate while masturbating.)

Advantages:

  • No hormones are used during a vasectomy. 
  • It will last forever. 
  • The procedure takes little time and has few risks. 
  • It is done in a clinic or doctor’s office as an outpatient procedure.

Disadvantages: 

  • Men may later regret their choice. 
  • A man can still get sexually transmitted diseases even after a vasectomy. 
  • After the procedure, most people feel pain for a short time.

Success Rate: 

The rate of failure is estimated to be about 0.1%.

Permanent Contraception In Women:

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Some women get a hysterectomy every year, which means their uterus, tubes, and ovaries are taken out. However, this is usually not done just to prevent pregnancy.

Tubal Ligation ( Tied Tubes)

This is a permanent contraception in women where the fallopian tubes are tied to prevent pregnancy the rest of her life.

  1. This can be done Immediately following delivery known as postpartum tubal ligation or
  2. Any other time outside delivery time known as Interval procedure

A postpartum tubal ligation is usually done through a small cut in the navel right after a vaginal delivery, or it can be done through an open cut during a cesarean section. 

For an interval procedure, small instruments are usually put into a woman’s abdomen after laparoscopy, in which a scope is put through the umbilicus.

Interval mini-laparotomy, which is a small incision in the bikini area of the abdomen, is usually the procedure of choice when there is a chance that the abdominal contents will shift or there will be adhesions, which could make it hard to finish the procedure laparoscopically. 

Most permanent contraception procedure in women are done while they are under general anesthesia.

The place the egg travels from the ovaries and where the sperm fertilizes the egg, known as the fallopian tubes can be obstructed with silastic rings, clips, bands, segmental destruction with electrocoagulation, or suture ligation with partial removal of a segment in each of the fallopian tubes (salpingectomy). 

By stopping the flow of sperm up the Fallopian tube, female permanent contraception stops fertilization.

Advantages:

  • There are no hormones involved in permanent contraception.
  • It is a permanent way to stop pregnancy. 
  • There are no changes in sexual desire (libido), the menstrual cycle, or the ability to breastfeed. 
  • Most of the time, the procedure is done as an outpatient procedure on the same day.

Disadvantages

  • The procedure requires either general or local anesthesia. 
  • It is a permanent way to prevent pregnancy, and some women may later regret their choice, especially the younger women.
  • Regret is hard to measure because it includes a wide range of complicated feelings that can change over time. This helps explain why, even though some studies have found that 26% of women have “regret,” less than 20% ask for reversal and less than 10% actually go through with it.
  • Permanent contraception does not protect a woman from sexually transmitted diseases,
  • It comes with all of the risks of surgery. Sometimes, a laparoscopic sterilization can’t be done, and an incision in the abdomen may be needed to reach the Fallopian tubes. There may be some discomfort in the short term.

Success Rate: 

  • Rates change depending on the procedure. Overall, about 18.5 of every 1,000 women who have the procedure become pregnant within 10 years. 
  • This is probably because the tubes didn’t close all the way. 
  • If you do get pregnant after the procedure, you are more likely to have an ectopic pregnancy (a pregnancy in a place other than the expected place in the uterus).

About The Essure System:

  • Women who want to have permanent contraception, use the Essure system, which involves putting a small metal implant into their Fallopian tubes. During the implantation procedure, the doctor puts one of the devices into each of the two Fallopian tubes.
  •  A special catheter (tube) is put through the vaginal opening, into the uterus, and then into the Fallopian tube. There’s no need for general anesthesia, and the procedure can be done in the doctor’s office. 
  • The device works by causing scar tissue to grow around the implant.
  • This blocks the Fallopian tube and stops the sperm from fertilizing the egg. There is also the Adiana system, which is a similar one that uses a silicone implant.
  • During the first three months, women can’t count on the implants to prevent pregnancy, so they have to use other methods. At three months, women have a final X-ray where dye is put in the uterus and an X-ray is taken to make sure the device is in the right place. 
  • Once placement is confirmed, you don’t need any other way to prevent pregnancy.
  • People say that the Essure device works 99.8 percent of the time.
  • One possible problem with the system is that not all women will be able to place both inserts correctly. Minor to moderate cramping, nausea, vomiting, dizziness, lightheadedness, bleeding, or spotting can happen during or right after the procedure.
  • This procedure cannot be reversed. This is a way to stop having children forever. 
  • Doctors sometimes have trouble putting the implants in place. 
  • If at all pregnancy occurs, there is a greater chance of being an ectopic pregnancy, which can be life-threatening and often needs emergency medical care.
  • Implants don’t protect against sexually transmitted diseases (STDs), just like other permanent contraception methods doesn’t.

References:

https://emedicine.medscape.com/article/258507-overview

https://www.emedicinehealth.com/birth_control_permanent_methods/article_em.htm