Sterilisation procedures are permanent surgical interventions to prevent conception.

The NHS does not provide reversal procedures. Private reversal procedures are available, but the success rate is low. Therefore, sterilisation should be considered permanent.

Female steralisation (Tubal occlusion)

MOA - Prevents sperm from meeting egg

• Typically performed by laparoscopy under general anasthesia, occlusion of the tubes using Filshie clips
• Alternatively fallopian tubes can be tied and cut, or removed altogether

Efficacy - more than 99% effective (1 in 200 failure rate)

Complications - Mortality, haemorrhage, infection

Advantages - long term, very low failure rate, reduces risk of ovarian cancer by 50%

Disadvantages - expensive, irreversible, very invasive (surgical risks)

Vasectomy

MOA - Involves cutting vas deferens, prevents sperm travelling from testes to ejaculated fluid

Efficacy - >99% (1 in 2000 failure rate), doesn't work immediately

• semen analysis needs to be performed twice following a vasectomy before a man can have unprotected sex (usually at 16 and 20 weeks)

complications: bruising, haematoma, infection, sperm granuloma, chronic testicular pain (affects between 5-30% men)

Advantages - long term, very low failure rate, quick procedure (performed under local anasthetic) so is less invasive then female steralisation

Disadvantages - expensive, irreversible, very invasive (surgical risks)

• the success rate of vasectomy reversal is up to 55%, if done within 10 years, and approximately 25% after more than 10 years