CDC Article-US Medical Eligibility Criteria for Contraceptive Use, 2010

Vol. 59 / RR-4 Recommendations and Reports 75
Appendix K
Female and Male Sterilization
Tubal sterilization for women and vasectomy for men are
permanent, safe, and highly effective methods of contraception.
In general, no medical conditions would absolutely restrict
a person’s eligibility for sterilization (with the exception of
known allergy or hypersensitivity to any materials used to
complete the sterilization method). However, certain conditions
place a woman at high surgical risk; in these cases, careful
consideration should be given to the risks and benefits of other
acceptable alternatives, including long-acting, highly effective,
reversible methods and vasectomy. Female and male sterilization
do not protect against sexually transmitted infections
(STIs) or human immunodeficiency virus (HIV). If risk exists
for STI/HIV (including during pregnancy or postpartum), the
correct and consistent use of condoms is recommended, either
alone or with another contraceptive method. Consistent and
correct use of the male latex condom reduces the risk for STIs
and HIV transmission.
Because these methods are intended to be irreversible, persons
who choose sterilization should be certain that they want
to prevent pregnancy permanently. Most persons who choose
sterilization remain satisfied with their decision. However, a
small proportion of women regret this decision (1%–26% from
different studies, with higher rates of regret reported by women
who were younger at sterilization) (1,2). Regret among men
about vasectomy has been reported to be approximately 5%
(3), similar to the proportion of women who report regretting
their husbands’ vasectomy (6%) (4). Therefore, all persons
should be appropriately counseled about the permanency of
sterilization and the availability of highly effective, reversible
methods of contraception.
References
1. Peterson HB. Sterilization. Obstet Gynecol 2008;111:189–203.
2. Hillis SD, Marchbanks PA, Tylor LR, Peterson HB. Poststerilization regret:
findings from the United States Collaborative Review of Sterilization.
Obstet Gynecol 1999;93:889–95.
3. Ehn BE, Liljestrand J. A long-term follow-up of 108 vasectomized
men. Good counselling routines are important. Scand J Urol Nephrol
1995;29:477–81.
4. Jamieson DJ, Kaufman SC, Costello C, et al. A comparison of women’s
regret after vasectomy versus tubal sterilization. Obstet Gynecol
2002;99:1073–9.