Training of Roma Health Mediators in Reproductive Health

Trainer document
VOLUNTARY SURGICAL CONTRACEPTION (presentation)
FEMALE SURGICAL STERILIZATION or TUBAL LIGATION
How Tubal Ligation Works
This method involves blocking the fallopian tubes by cutting and tying or applying clips,
rings, or bands. The sperm cannot travel beyond the blocked area and cannot reach the
female egg or ovum, so there is no fertilization.
Effectiveness
Is very high and depends on the surgical technique: less than 1 pregnancy per 200 women
during the first year of use.
Common Immediate Side Effects
• Pain at the operation site
• Fever after the operation
• Bleeding from the skin near the operation site
MALE SURGICAL STERILIZATION or VASECTOMY
Is one of the safest, simplest, and most effective methods of contraception. The two Vas
Deferens are tied at two places and cut.
How Vasectomy Works
Sperm is produced in the man’s testes. The two tubes (vas deferens) that carry sperm
from both the testes to the urethra in the penis are cut and blocked. After the minor
operation, the sperm produced in the testes cannot travel beyond the blocked ends of the
vas deferens and can no longer enter the male seminal fluid (semen). However, the semen
becomes sterile, or completely free of sperm, only after 20 ejaculations. Condoms or
another contraceptive method should be used until then.
Vasectomy is not castration, where testes are removed. With vasectomy, the function of
testes (sperm and male hormone production) is not affected; both continue to be
produced. Sperm are reabsorbed by the body. The male hormones circulate via the
blood vessels which are not effected by the vasectomy. The male hormones stimulate the
man to have erections, sex drive, feelings, and ejaculations as before. A man may even
feel his sex drive increase since he no longer has to worry about getting his partner
pregnant. The amount, smell, appearance, and thickness of semen after the vasectomy
appear the same as before.
Effectiveness
It is one of the most effective methods of contraception. It is more effective than COCs,
IUDs or condoms. The failure rate is less than 1 pregnancy in 200 women in the first
year.
The most common cause of pregnancy after vasectomy is failure to use a contraceptive
during the first 20 ejaculations or for 3 months after surgery.
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RFHI/JSI Romania Training of RHMs in Reproductive Health Session 4: FP Methods