The risk of pregnancy after tubal sterilization: Findings from the U.S. Collaborative Review of Sterilization☆,☆☆,★
Section snippets
MATERIAL AND METHODS
The U.S. Collaborative Review of Sterilization is a prospective study of women undergoing tubal sterilization at medical centers in Baltimore, Maryland; Buffalo, New York; Chapel Hill, North Carolina; Honolulu, Hawaii; Houston, Texas; Memphis, Tennessee; Sacramento, California; St. Louis, Missouri; and San Francisco, California. The study was approved by the institutional review board in each center. This report is based on the experiences of women who entered the study from 1978 through 1986.
RESULTS
Of the 10,863 women enrolled in the U.S. Collaborative Review of Sterilization who met the inclusion criteria for this analysis, 178 were excluded from analysis. One hundred thirty-six of these women were excluded because of loss to follow-up (n = 116), refusal to be interviewed at 1-month follow-up (n = 17), or refusal after prolonged loss to follow-up (n = 3). Eight women were excluded because of hysterectomy (n = 4), repeat tubal sterilization (n = 1), or death at 1-month follow-up (n = 3;
COMMENT
We found all methods of tubal sterilization to be highly effective in reducing the risk of pregnancy. However, the failure rates of most methods were substantially higher than those from most previous reports.4, 5, 6, 7, 8
All methods of tubal occlusion require proper application to maximize effectiveness. The higher failure rates associated with sterilization by spring clip application and bipolar coagulation highlight the need for proper technique in the use of these methods. As described by
Acknowledgements
The U.S. Collaborative Review of Sterilization Working Group: Design, Coordination, and Analysis Center, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia. Principal Investigator: Herbert B. Peterson, MD; Project Officer: Joyce M. Hughes; Project Associates: Zhisen Xia, PhD, Lynne S. Wilcox, MD, and Lisa Ratliff Tylor; Project Consultant: James Trussell, PhD; Data Collection Centers
References (25)
- et al.
An epidemiologic study of risk factors associated with pregnancy following female sterilization
AM J OBSTET GYNECOL
(1980) - et al.
A comparison of different laparoscopic sterilization occlusion techniques in 24,439 procedures
AM J OBSTET GYNECOL
(1982) - et al.
Ectopic pregnancy subsequent to laparoscopic sterilization
AM J OBSTET GYNECOL
(1989) High rate of ectopic pregnancy following laparoscopic tubal coagulation failures: incidence and etiology
AM J OBSTET GYNECOL
(1980)- et al.
Risk factors for regret after tubal sterilization: 5 years of follow-up in a prospective study
Fertil Steril
(1991) - et al.
Deaths attributable to tubal sterilization in the United States, 1977-1981
AM J OBSTET GYNECOL
(1983) - et al.
The subsequent course of patients sterilized by tubal ligation
AM J OBSTET GYNECOL
(1951) - et al.
Contraceptive use in the United States, 1973-1988
(1990) Contraceptive use in the United States: 1982-90
(1995)Inc. SAS/STAT software: changes and enhancements
(1992)
Sterilization failures in Singapore: an examination of ligation techniques and failure rates
Stud Fam Plann
Tubal sterilization: findings in a large, prospective study
Br J Obstet Gynaecol
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From the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention,aand the Office of Population Research, Princeton University.bA complete list of the U.S. Collaborative Review of Sterilization Working Group appears at the end of the article.
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Reprint requests: Herbert B. Peterson, MD, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mailstop K-34, 4770 Buford Highway, N.E., Atlanta, GA 30341-3724.
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