When a woman or a couple becomes certain they want no more children, or no children at all, they may want to consider the option of permanent birth control or sterilization.
The next major issue is who should get sterilized, the man or the woman?
Vasectomy Or Tubal Ligation ?
There is no doubt that sterilization for men, or vasectomy, is a much simpler operation than female sterilization or tubal ligation. During a vasectomy, the vas deferens, which normally carries the sperm from the testicle to the penis is cut on each side. This operation is not only safe and uncomplicated, but it can be done under local anesthetic and takes only half an hour. Although vasectomy is essentially irreversible, if reversal is desired, it is easier to do than after female sterilization. The vas can be put back together or re-anastomosed in 40 to 90 percent of cases with pregnancy resulting in 18-60 percent of those successful operations.
Although both are very low, the pregnancy rate after vasectomy is somewhat lower than after a tubal ligation. And there isn't the problem of a tubal pregnancy after a failed tubal ligation, which can pose a serious health threat to women.
Furthermore, following vasectomy, complications are infrequent and of a minor nature. No long-term side effects from vasectomy have as yet been proven.
The female procedure has a five times greater incidence of major complications than vasectomy.
In female sterilization or tubal ligation, the fallopian tubes that connect the ovaries to the uterus are cut, burned or blocked so that the egg cannot travel to meet the sperm in the vagina. Tubal ligation requires the use of an operating room, sophisticated medical equipment, the services of an anesthetist and a gynecologist trained in the use of the laparoscope. Like vasectomy, tubal ligation is best considered irreversible.
However, with recent advances in microsurgery, in anywhere from between 30 and 60 percent of cases, the tubes can be successfully sewn back together or reconstructed. But only 40 percent of women with successful tubal reconstruction will go on to become pregnant. This means your overall chance of becoming pregnant after a reversal is really only 12-20 percent.
Chances For Reversal
Your chances for reversal depend on the type of operation that was done and how much of the tube was destroyed.
Where the tubes are burned or cauterized (the most common operation) the tubal ligation is more difficult to reverse. Where clips, bands, or rings are used, less tissue is damaged and the operation can be reversed a little more easily. Also these reversal rates apply only to a large medical center where the operation is performed by a gynecologist experienced in tubal reconstructions.
The reversal procedures itself is a lengthy operation involving major abdominal surgery unlike the original tubal ligation. With any major abdominal surgery, the risk of complications and length of recovery period increases.
The cost of the surgery is not covered by medical plans and must be paid by the patient. Currently a reversal operation costs about $2,000 in Canada. With anesthetic charges and hospital costs, this may add up to between $3,200 and $6,000 in some provinces.
The possibility of reversal should definitely not be counted on in making the decision in favour of either male or female sterilization.
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