Commentary

Intrauterine contraception as an alternative to interval tubal sterilization

Current use of female sterilization

Female sterilization has played a dominant role in family planning in the United States for decades. As of the 2002 National Survey of Family Growth, female sterilization was the second most common means of fertility regulation among women of reproductive age (17%) [3]. Only oral contraceptives (19%) were used by more women.

Several personal characteristics are strongly linked with female surgical sterilization. While the proportion of women having female sterilization procedures increases with

IUD vs. interval tubal sterilization

Long-term contraception with an IUD and tubal sterilization share common features as well as important differences (Table 1). An office-based procedure, insertion of an IUD is more convenient and rapid than tubal sterilization, which requires use of an operating room. IUD insertion is technically simple and can be performed by clinicians with a wide range of medical training; interval tubal sterilization by laparoscopy or laparotomy is moderately complex and requires sterile surgical supplies,

Conclusion

Both intrauterine contraception and tubal sterilization are “top-tier” methods of fertility regulation with comparable high effectiveness [31]. Both offer convenient “forgettable contraception” that lasts for years, and both have important noncontraceptive benefits [25], [28], [32]. A small but important minority of women who undergo tubal sterilization later regret their decision, and some of them pursue expensive and inconvenient remedies. All women, particularly young women, who are at high