Female and male sterilization are both safe and effective methods of permanent contraception used by more than 220 million couples worldwide (1). Approximately 600,000 tubal occlusions and 200,000 vasectomies are performed in the United States annually (2–4). For women seeking permanent contraception, sterilization obviates the need for user-dependent contraception throughout their reproductive years and provides an excellent alternative for those with medical contraindications to reversible methods. The purpose of this document is to review the evidence for the safety and effectiveness of female sterilization in comparison with male sterilization and other forms of contraception.
This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Any updates to this document can be found on www.acog.org or by calling the ACOG Resource Center.
While ACOG makes every effort to present accurate and reliable information, this publication is provided "as is" without any warranty of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented.
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Number 208 (Replaces Practice Bulletin Number 133, February 2013)
Committee on Practice Bulletins—Gynecology. This Practice Bulletin was developed by the Committee on Practice Bulletins—Gynecology in collaboration with Alison Edelman, MD, MPH; Elizabeth Micks, MD, MPH; and Deborah Bartz, MD, MPH.
INTERIM UPDATE: The content on hysteroscopic sterilization in this Practice Bulletin has been updated as highlighted (or removed as necessary) to reflect the withdrawal of the Essure® device from the market. The information on salpingectomy for sterilization also has been revised as highlighted to be consistent with current ACOG guidance on salpingectomy for ovarian cancer prevention.
Published online on January 11, 2019.
Copyright 2019 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.
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Benefits and risks of sterilization. ACOG Practice Bulletin No. 208. American College of Obstetricians and Gynecologists. Obstet Gynecol 2019:133:e194–207.