Sterilisation is a permanent method of contraception, suitable for people who are sure they never want children or do not want more children. You may want to find out about other long-term methods of contraception which are as effective as sterilisation but reversible. Ask your doctor or nurse.

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Questions and answers
How effective is sterilisation?
What are the advantages of sterilisation?
What are the disadvantages of sterilisation?
Can anyone be sterilised?
Where can I go for advice on sterilisation?
What information should I receive before I decide to be sterilised?
Do I need my partner's permission?
Can sterilisation be reversed?

Male sterilisation (vasectomy)
What is a vasectomy?
What is the operation like?
How will I feel after the operation?
Are there any serious risks or complications?
When will a vasectomy be effective?

Female sterilisation (tubal occlusion)
What is female sterilisation?
What is the operation like?
How will I feel after the operation?
Are there any serious risks or complications?
When is female sterilisation effective?

A final word

How effective is sterilisation?

Male sterilisation (vasectomy) - About 1 in 2000 male sterilisations fail.

Female sterilisation - The overall failure rate is about 1 in 200. Research suggests that when the sterilisation is done using a type of clip known as the Filshie clip, the failure rate in the ten years after the operation may be lower (1 in 333-500).

There is a risk that sterilisation will not work. The tubes that carry the sperm in men and the eggs in women can rejoin after sterilisation. This can happen immediately or some years after the operation has been carried out. So if the woman ever thinks she might be pregnant, she should see a doctor or nurse as soon as possible.

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What are the advantages of sterilisation?
• It does not interrupt sex.
• After sterilisation has worked you don't have to do anything about contraception ever again.

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What are the disadvantages of sterilisation?
• The tubes may rejoin and you will be fertile again. This is not common.
• Sterilisation cannot be easily reversed.
• Sterilisation does not protect you against sexually transmitted infections.
• It takes at least two months for a vasectomy to be effective.

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Can anyone be sterilised?
Sterilisation is for people who are sure they do not want more children or any children. You should not decide to be sterilised if you or your partner are not completely sure or if you are under any stress, for example after a birth, miscarriage, abortion or family or relationship crisis.

Research shows that more women and men regret sterilisation if they were sterilised when they were under 30, had no children or were not in a relationship. Because of this, young or single people may receive extra counselling.

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Where can I go for advice on sterilisation?
You can go to a family planning clinic, your GP or practice nurse. If you prefer not to go to your own practice, or they don't provide contraceptive services, they will refer you to another practice or clinic. All treatment is confidential and free. In some areas, NHS waiting lists for sterilisation can be quite long. You can pay to have the operation done privately.

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What information should I receive before I decide to be sterilised?
You should get full information and counselling if you want to be sterilised. This gives you a chance to talk about the operation in detail and any concerns you might have.

You should be told about:

• other highly effective long-term but reversible methods of contraception
• both male and female sterilisation, their failure rates, any possible complications and reversal difficulties.

Anyone being sterilised will have to sign a consent form.

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Do I need my partner's permission?
By law you do not need your partner's permission, but some doctors prefer both partners to agree to the operation after information and counselling.

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Can sterilisation be reversed?
Sterilisation is meant to be permanent. There are reversal operations, but they are not always successful. The success will depend upon how and when you were sterilised. Reversal is rarely available on the NHS and can be difficult and expensive to obtain privately.

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Male sterilisation (vasectomy)

What is a vasectomy?
The tubes (vas deferens) that carry sperm from your testicles to your penis are cut, sealed or blocked.

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What is the operation like?
You will be given a local anaesthetic. To reach the tubes, the doctor will make either a small cut or puncture, known as the no-scalpel method, in the skin of your scrotum. The doctor will then cut the tubes and close the ends by tying them or sealing them with heat. Sometimes a small piece of the tubes is removed when they are cut. The opening(s) in your scrotum will be very small and you may not need to have any stitches afterwards. If you do, dissolvable stitches or surgical tape will be used. The operation takes about 10-15 minutes and may be done in a clinic, hospital outpatient department or doctor's surgery. Sometimes it is necessary to do the operation using a general anaesthetic, but this is not common.

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How will I feel after the operation?
Your scrotum may become bruised, swollen and painful. Wearing tight-fitting underpants, to support your scrotum, day and night for a week may help. You should avoid strenuous exercise for at least a week. For most men pain is quite mild and they do not need further help. The doctor or nurse should give you information about how to look after yourself.

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Are there any serious risks or complications?
Research shows that there are no known serious long-term health risks caused by having a vasectomy.

Occasionally, some men have bleeding, a large swelling or an infection. In this case, see your doctor as soon as possible. Sometimes sperm may leak out of the tube and collect in the surrounding tissue (sperm granuloma). This may cause inflammation and pain immediately, or a few weeks or months later. If this happens, it can be treated.

Some men may experience ongoing pain in their testicles. This is known as chronic pain. Treatment for this is often unsuccessful.

The large majority of men having a vasectomy will have a local anaesthetic, but sometimes a general anaesthetic is used. All operations using a general anaesthetic carry some risks, but serious problems are rare. For more information on anaesthetics visit the website: www.youranaesthetic.info.

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When will a vasectomy be effective?
You need to use an extra method of contraception after the operation because sperm are left in the tubes that lead to the penis. The rate these sperm are used up varies from man to man. About eight weeks after the operation, you should have a semen test to see if the sperm have gone. Sometimes more than one test is needed. You can have sex as soon as it is comfortable, but you can only rely on a vasectomy for contraception after you have been told that the semen test is negative.

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Female sterilisation (tubal occlusion)

What is female sterilisation?
Your fallopian tubes are cut, sealed or blocked by an operation. This stops the egg and sperm meeting. Your ovaries, womb and cervix are left in place so you will still release an egg each month, but it is absorbed naturally by your body. Your sex drive and enjoyment of sex should not be affected. For many women it is improved, as they no longer fear an unplanned pregnancy.

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What is the operation like?
There are several ways of blocking the fallopian tubes: tying, cutting and removing a small piece of the tube; sealing; or applying clips or rings. A new method of blocking the tubes using a small titanium (metal) insert is being tested. As yet, it is not widely available.

There are two main ways of reaching the fallopian tubes - laparoscopy or mini-laparotomy. You should be told which method is being used and why it has been chosen.

Laparoscopy is the most common method. You will be given a general anaesthetic or possibly a local anaesthetic. A doctor will make two tiny cuts, one just below your navel and the other just above the bikini line. They will then insert a laparoscope, which lets the doctor clearly see your reproductive organs. The doctor will seal or block your fallopian tubes, usually with clips or rings.

For a mini-laparotomy you will usually have a general anaesthetic and spend a couple of days in hospital. The doctor will make a small cut in you abdomen, usually just below the bikini line, to reach your fallopian tubes.

The time you stay in hospital after sterilisation depends on the anaesthetic and the method used. It can be as little as one day.

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How will I feel after the operation?
If you have a general anaesthetic you may feel unwell and a little uncomfortable for a few days. This is not unusual and you may have to take things easy for a week or so. You may have some slight bleeding and pain. If this gets worse, see your doctor. Your doctor should tell you how the operation was done, if there were any complications and how to look after yourself.

Occasionally, some women find that their periods become heavier. This is usually because of their age or because they have stopped using hormonal contraception, which may have lightened their periods.

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Are there any serious risks or complications?
If female sterilisation fails, and you do become pregnant, there is a small increased risk of you having an ectopic pregnancy. An ectopic pregnancy develops outside your womb, usually in the fallopian tube. Although this is not common, it is dangerous. You should see your doctor straight away if you think you might be pregnant or have a light or delayed period, unusual vaginal bleeding, or if you have sudden or unusual pain in your lower abdomen.

All operations carry some risk, but the risk of serious complications is low.

For more information on anaesthetics visit the website: www.youranaesthetic.info.

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When is female sterilisation effective?
You can have sex as soon as it is comfortable, but if you do not want to become pregnant you must continue to use contraception until your first period after sterilisation.

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