Few women regret sterilization procedures

Few of the women who undergo tubal sterilization or whose husbands undergo vasectomy later go on to regret either procedure, according to a study funded by the National Institute of Child Health and Human Development (NICHD) and conducted by the Centers for Disease Control and Prevention (CDC). The study appears in the June issue of Obstetrics & Gynecology.

The study found the proportion of women who experience regret was essentially the same -about 6 to 7 percent-five years after their husbands’ vasectomy or their own tubal sterilization. The study also found that substantial conflict between a woman and her husband increases the risk of regret after either vasectomy or tubal sterilization.

“This study is reassuring in that a comparatively small number of the women in the study experienced regret after either they or their husbands underwent a voluntary sterilization procedure,” said Duane Alexander, M.D., Director of the NICHD. “However, the finding also underscores the importance of the health care professional in providing thorough counseling for those considering sterilization as a means of family planning.”

The researchers, Denise J. Jamieson, M.D. and her colleagues, analyzed data from The U.S. Collaborative Review of Sterilization (CREST), which enrolled women ages 18 to 44 who underwent tubal sterilization at medical centers in six cities around the country between 1985 and 1987. This analysis included data collected from 3,672 sterilized women and 525 other women whose husbands underwent vasectomy, all of whom were asked about regret at follow up visits throughout the course of the study.

Although earlier CREST papers addressed the probability of regret among a larger group of sterilized women, the current report is the first to evaluate regret among women whose husbands underwent vasectomy and to make comparisons to women undergoing tubal sterilization.

The researchers found that the chance of a woman experiencing regret within 5 years after her husband’s vasectomy was only 6.1 percent, a figure which did not differ significantly from the 7.0 percent of women who, 5 years later, regretted tubal sterilization.

“It’s reassuring that such large percentages of those who chose either vasectomy or tubal sterilization were satisfied with their decisions,” said one of the paper’s authors, Steven Kaufman, M.D., of NICHD’s Contraception and Reproductive Health Branch. Similarly, the researchers found that the overall cumulative probability of the woman requesting that the vasectomy be reversed was low-2.0 percent-and statistically indistinguishable from the corresponding figure (2.2 percent) for women requesting reversal of tubal sterilization.

Women who experienced substantial conflict with their husbands before the husbands’ vasectomy were more than 25 times as likely to request that their husbands undergo vasectomy reversal as those who did not experience such conflict. Among couples with substantial conflict prior to tubal sterilization, the woman was about 3 times as likely to express regret and 5 times as likely to request reversal as those not reporting such conflict. The study did not ask women to specify the nature of the conflict, so the authors do not know whether the conflicts were about the sterilization procedure or about other matters.

“In counseling patients about contraceptive options, the probability of regret associated with both male and female sterilization should be addressed, as should the possibility of regret associated with unintended pregnancy for women who do not choose a highly effective method of contraception,” the investigators wrote.

The NICHD is part of the National Institutes of Health, the biomedical research arm of the federal government. The Institute sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD publications, as well as information about the Institute, are available from the NICHD Web site, http://www.nichd.nih.gov, or from the NICHD Clearinghouse, 1-800-370-2943; e-mail NICHDClearinghouse@mail.nih.gov.