a; Zhisen Xia, PhDa; Joyce M. Hughesa; Lynne S. Wilcox, MDa; Lisa Ratliff Tylora; James Trussell, PhDb; For the U.S. Collaborative Review of Sterilization Working Group">
The risk of pregnancy after tubal sterilization: Findings from the U.S. Collaborative Review of Sterilization☆☆☆★
Presented by invitation at the Fourteenth Annual Meeting of the American Gynecological and Obstetrical Society, Napa, California, September 7-9, 1995.
Abstract
OBJECTIVE: Our purpose was to determine the risk of pregnancy after tubal sterilization for common methods of tubal occlusion. STUDY DESIGN: A multicenter, prospective cohort study was conducted in U.S. medical centers. A total of 10,685 women who underwent tubal sterilization was followed up for 8 to 14 years. The risk of pregnancy was assessed by cumulative life-table probabilities and proportional hazards models. RESULTS: A total of 143 sterilization failures was identified. Cumulative 10-year probabilities of pregnancy were highest after clip sterilization (36.5/1000 procedures) and lowest after unipolar coagulation (7.5/1000) and postpartum partial salpingectomy (7.5/1000). The cumulative risk of pregnancy was highest among women sterilized at a young age with bipolar coagulation (54.3/1000) and clip application (52.1/1000). CONCLUSIONS: Although tubal sterilization is highly effective, the risk of sterilization failure is higher than generally reported. The risk persists for years after the procedure and varies by method of tubal occlusion and age. (AM J OBSTET GYNECOL 1996;174:1161-70.)
☆ 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.
☆☆ 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.
ABSTRACT