ACOG guidelines at a glance
A commentary on ACOG Practice Bulletin Number 133: Benefits and risks of sterilization
Committee on Practice Bulletins-Gynecology
ACOG Practice Bulletin Number 133: Benefits and Risks of Sterilization, February 2013 (Replaces Practice Bulletin Number 46, September 2003). Obstet Gynecol. 2013;121:392-404. Full text of ACOG Practice Bulletin is available to ACOG members at http://www.acog.org/Resources_And_Publications/Practice_Bulletins/Committee_on_Practice_Bulletins_--_Gynecology/Benefits_and_Risks_of_Sterilization.
Benefits and Risks of Sterilization
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 comparisonwith male sterilization and other forms of contraception.
Used with permission. Copyright the American College of Obstetricians and Gynecologists.
COMMENTARY
Benefits and Risks of Sterilization:
Considering all the options
By Paula J. Adams Hillard, MD
Dr. Hillard is Professor, Department of Obstetrics and Gynecology Stanford University School of Medicine, Stanford, California, and a member of the Contemporary OB/GYN Editorial Board.
Sterilization remains an important method of limiting family size, and is particularly popular in the United States. The landscape of both permanent and reversible contraception has changed since the 2003 version of the American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin on sterilization. Practice Bulletin Number 133: Benefits and Risks of Sterilization, replaces the 2003 Bulletin.
Rates of female sterilization increased dramatically in the 1970s, peaked in 1977, were stable through the 1980s and early 1990s, but have declined since. More recently, use of long-acting reversible contraception (LARC) including intrauterine devices (IUDs) and the subdermal implant has increased; these methods are comparable to sterilization in efficacy, but are reversible and do not require a surgical procedure.
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