Tubal ligation and vasectomy: advantages and disadvantages

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Many couples, when they consider that their desire for paternity has been fulfilled, consider the option of using contraception to avoid a new pregnancy.

Normally, having this decision clear, they opt directly for permanent sterilization techniques. However, this sometimes implies that, in the future, if you change your mind, it will be costly to recover fertility. Therefore, we encourage you to consult previously what options you have and what each one consists of.

The most used permanent sterilization techniques are:

  • Tubal ligation, in the case of women.
  • Vasectomy, for man.

Below you have an index with all the points that we will discuss in this article.

Index

Tubal ligation and vasectomy: advantages and disadvantages

Tubal ligation

Tubal ligation is a surgical intervention that consists in blocking the tubal conduits to prevent ovum and sperm from being found, since it is precisely in the tube where fertilization takes place.

The obstruction can be done using staples, clips or rings that pinch the tube and, later, cutting or not cutting the portion that remains between the pieces.

Many women take advantage of the cesarean to perform this intervention and thus avoid going through the operating room again and undergoing anesthesia. If done at another time, it can be done in two ways:

  • Laparoscopy: it is done by means of a few abdominal incisions, without the need of practicing an open surgery.
  • Hysteroscopy: through a camera that is inserted through the vagina, you reach the uterus and occlusion is practiced.


Is it irreversible?

Although the decision to undergo tubal ligation is made clear that you do not want to have more children, there are few women who repent. Therefore, the question about whether this surgery is definitive is inevitable when considering resorting to it.

The process contrary to ligation is called tubal repermeabilization and technically is more complicated than obstruction surgery.

Can pregnancy be achieved after ligation?

The possibility of becoming pregnant again will depend on the age you have at the time of repermeabilization and what type of obstruction was practiced in the tubes, because there are certain methods that prevent re-joining the ducts.

Alternatives to the reversion of the ligature

When it is not possible to undo the occlusion, or even being able to revert, there are other fertility problems that prevent pregnancy, it is necessary to resort to assisted reproduction techniques. In this case, artificial insemination is completely ruled out, since the blocked tubes can not produce fertilization. Therefore, in vitro fertilization is used directly.

The IVF process begins with ovarian stimulation: hormones are used to increase the number of follicles that grow in the ovaries in order to obtain a greater number of ovules in the follicular puncture. In the laboratory, the oocytes are fertilized with the sperm of the couple and the generated embryos are transferred to the uterus of the mother.

This process does not require that the tubes be permeable, therefore it is a compatible option, both in case of irreversible ligation, or if it is a pathology that obstructs the passage through the tubes.

The Spanish Law on Assisted Reproduction includes the possibility of transferring up to three embryos per transfer, so the couple can agree with the gynecologist, taking into account their options, how many embryos they want to transfer. However, in CREA we bet on the transfer of a single embryo, since it avoids both multiple pregnancy and its associated complications. The application of the single transfer entails, in addition, a reduction in costs and expenses in health by reducing those implied by a multiple gestation. In CREA we have been applying our Single Embryo Transfer Program for 5 years and, in fact, 70% of the ovodonations we have performed have been made with the transfer of a single embryo, maintaining one of the highest pregnancy rates nationwide.


hysteroscopic surgery in Huelva(Spain)

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