Vasectomy vs. Tubal Ligation

Across the globe, sterilization is considered as the most reliable method to achieve permanent contraception or birth control. However, despite widespread popularity and potential benefits, many couples remain clueless regarding the most suitable procedure to achieve sterilization.

Broadly speaking, permanent contraception or sterilization can be achieved via either of these methods:

• Vasectomy (in case of men)
• Tubal ligation (in case of women)

In US, vasectomy has been outnumbered by tubal ligation in a ratio of 1:2 however the experts believes that this ratio can be reversed (especially if people become more aware and well informed about this topic).

Dynamics of Vasectomy and Tubal Ligation

Apparently both the procedures seem quite similar in dynamics. It is noteworthy that both these procedures prevent any future pregnancies permanently, as egg and sperms fail to come in direct contact thereby preventing fertilization. The vasectomy process involves the division and sealing of the vas deferens – the ducts that are responsible for transferring the sperms to the ejaculatory ducts, to allow possible conception. On the other hand tubal ligation is performed at the level of fallopian tubes – the tubes where the process of fertilization takes place (or egg meet the sperm/sperms).

Statistically, both the procedures have a success rate of greater than 99%. It must be noted that vasectomies aren’t effective immediately after the procedure therefore the chances of pregnancy is fair (at least in the first few weeks following the procedure) unless alternative birth control methods are used. It is also important to conduct semen analysis even several weeks after the vasectomy is performed as sperms may continues to appear in the semen for up to 3-4 weeks post-surgery. Experts recommend semen analysis to ensure that the sperms has stopped appearing in the semen before opting for unprotected intercourse.

What are some common complications/ adverse effects after these procedures?

A major upside of the two procedures is that, there are none or typically minor complications associated with these procedures. For instance, very little bleeding may occur as part of the surgical process which may result in the for

mation of a small blood clot or hematoma beneath the skin. In some cases, a mild infection at the site may occur where incision is made. Fortunately, no treatment/ intervention whatsoever is needed as these ailments resolve spontaneously.

Major complications are often associated with tubal ligation, mostly because of the location of the fallopian tubes within the abdomen; hence it becomes difficult for the surgeons to reach the tubes as compared to the vas deferens in males. Tubal ligation is often carried out by making rather small incisions in the wall of abdomen and patient is given a general anesthetic agent. There is always a mild chance of injury to the internal organs such as uterus or a major blood vessel (if procedure is performed in hands of an inexperienced practitioner) leading to serious bleeding.

Unlike tubal ligation, vasectomy requires only a tiny incision in the scrotum and the patient is given a local anesthetic agent instead of general. Even when the risk of death is almost negligible with both the birth control procedures, a woman who undergoes tubal ligation is more at risk of death than a man who undergoes the procedure of vasectomy. The estimated death rate is 4 in 100,000 of women whereas for men it is close to zero. Likewise, the failure rate of tubal ligation is 1 in 200 cases according to a new study reported in the British Medical Journal (1).

Vasectomy vs. Tubal Ligations – What to choose?

When it comes to deciding between which sterilization procedures to opt for, one does not only see the compliance, but also the average cost that covers the entire procedure. Tubal ligation is comparatively more expensive and is thrice as costly as the vasectomy. The results of a nationwide study to compare between the two procedures showed that the cost of tubal ligation is up to $1,190 to $2,466; whereas vasectomy costs up to $353-$753.

Most couples make their decision between tubal ligation and vasectomy based on their non-medical issues. According to a new research, the partner who is more strongly against the future pregnancies is more likely to undergo the sterilization method.

The fact remains the fact, both tubal ligation and vasectomy remains extremely reliable procedures for birth control to date and are suitable for both women and men who want to prevent future pregnancies. However before opting for vasectomy or tubal ligation, you must think it through. Some people change their mind after opting for these procedures and attempt for reversal in order to restore fertility. All these individuals can get benefitted from techniques like vasectomy reversal or ligation reversal that involves sowing back of the severed ends of vas deferens or fallopian tubes respectively. Following this second procedure, pregnancy rates are modest (less than 30-60%). The future pregnancies rate after the reversal surgery is comparatively higher for vasectomy. Since the success rate is not beyond the expectation in both the sterilization methods, therefore giving it a consideration and consultation with your physician is of great importance.

References

1. Jamel, S., Malde, S., Ali, I. M., & Masood, S. (2013). Vasectomy. BMJ, 346.

2. Anderson, J. E., Jamieson, D. J., Warner, L., Kissin, D. M., Nangia, A. K., & Macaluso, M. (2012). Contraceptive sterilization among married adults: national data on who chooses vasectomy and tubal sterilization. Contraception, 85(6), 552-557.

3. Sharma, V., Le, B. V., Sheth, K. R., Zargaroff, S., Dupree, J. M., Cashy, J., & Brannigan, R. E. (2013). Vasectomy demographics and postvasectomy desire for future children: results from a contemporary national survey. Fertility and sterility, 99(7), 1880-1885.