Contraception - Female Sterilisation

Monday 15th February 2010

Female sterilisation is an effective and permanent form of contraception.

The operation usually involves cutting, sealing or blocking the fallopian tubes, which eggs travel through from the ovaries to the womb. This prevents the eggs from reaching the sperm and becoming fertilised.

How popular is it?

Every year, thousands of UK couples choose sterilisation as their method of contraception. It has become increasingly popular since the late 1960s. In 2001, one in 10 women aged under 50 was sterilised in the UK.

Who is it for?

Almost any woman can be sterilised. However, sterilisation should only be considered by women who do not want any more children, or do not want children at all. Once you are sterilised, it is very difficult to reverse the process (see Risks, above), so it is important to consider the other options available (see box, right).

Surgeons are more willing to perform sterilisation for women who are over 30 and who have had children, although some younger women who have never had a baby choose it.

How effective is it?

Female sterilisation is more than 99% effective, and only one in 200 women will become pregnant after the operation. It can be reversed, but the success rate is much smaller, with only 50-80% of fertility returning, depending on age and what sterilisation methods were used.

How sterilisation is carried out

Sterilisation is usually done using a technique called tubal occlusion (blocking the fallopian tubes), where a cut is made in your abdominal wall to access your fallopian tubes.

In 2004, the National Institute for Health and Clinical Excellence (NICE) published guidelines (see Useful links) on a relatively new technique that does not involve cutting into the body. This is called hysteroscopic sterilisation, and involves inserting implants into the fallopian tubes. However, the technique is not yet widely available.

Both procedures are described below.

Tubal occlusion

First, doctors need to examine your reproductive organs, using either laparoscopy or mini-laparoscopy.

Laparoscopy

This is the most common method of accessing the fallopian tubes. The doctor makes a small cut in your abdominal wall, and inserts a laparoscope (a long, thin tube with a tiny camera lens attached), which lets them clearly see your fallopian tubes. Additional cuts can be made if other instruments, such as surgical scissors, need to be inserted.

Mini-laparoscopy

This involves a smaller incision than a laparoscopy (usually less than two inches), just above the pubic hairline. The fallopian tubes are pulled out of the incision, operated on, and then put back into place. This procedure may be appropriate for women who have just had a baby, or have had recent abdominal or pelvic surgery.

Blocking the tubes

The fallopian tubes can be blocked using one of the following methods:

• Applying clips: plastic or titanium clamps are closed over the fallopian tubes.
• Applying rings: a small loop of the fallopian tube is pulled through a silicone ring, then clamped shut.
• Tying and cutting the tube: this destroys 3-4cm of the tube.
• Sealing the tubes (electrocoagulation): a harmless electrical current is used to burn a small portion of each fallopian tube and seal it closed.

Fallopian implants

These are usually inserted under local anaesthetic. A tiny piece of titanium metal called a microinsert is guided through your vagina and cervix and into each of your fallopian tubes, using a small flexible tube (a hysteroscope) and a guidewire. This means that the surgeon does not need to cut into your body.

The implant causes the fallopian tube to form scar tissue around it, which eventually blocks the tube.

Removing the tubes (salpingectomy)

If blocking the fallopian tubes has been unsuccessful, the tubes may be completely removed. Removal of the tubes is called salpingectomy.

Recovering from sterilisation

Your doctor will tell you what to expect and how to care for yourself after surgery.

If you have had a general anaesthetic, you should not drive a car for 12 hours after the operation. If you leave hospital within hours of the operation, do not try to drive home. Ask a relative or friend to pick you up, or take a taxi.

How you will feel

It is normal to feel unwell and a little uncomfortable for a few days if you had a general anaesthetic. You may have to rest for about a week.

Also, you may notice some slight bleeding and pain. There is no need for concern, but see your GP if it gets worse.

Having sex

Your sex drive and enjoyment of sex will not be affected. You can have sex as soon as it is comfortable to do so after the operation, but if you had tubal occlusion, you will need to use contraception until your first period to protect yourself from pregnancy.

If you had an implant fitted, you will need to use another form of contraception for the first three months after surgery. After three months, X-rays will be used to check that the implants are in the correct position.

Remember, sterilisation will not protect you from sexually transmitted infections, so continue to use barrier contraception, such as condoms, if you are unsure of your partner's sexual health.

This information was sourced from the NHS website.

Image: FreeDigitalPhotos.net

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Eat To Boost Fertility

Tuesday 24th November 2009

It is guest blogger time again so please welcome todays guest blogger Omo Franca who has written a brilliant blog on the topic of fertility and conception, babyfertile.blogspot.com, so make sure you pay it a visit.

EAT TO BOOST FERTILITY!

Having trouble getting pregnant? Experts now believe that following the right diet could be the single most important factor for successful conception.

A Spanish study recently found that men could boost their sperm counts by eating less red meat and fatty food, and more fruit and veg.

Meanwhile, research at Harvard University also found that women who made dietary changes reduced their risk of infertility by as much as 80%.
“The food choices you and your partner make can have a major effect on improving fertility,” agrees fertility expert Dr Zita West, whose client list includes actresses Kate Winslet, Cate Blanchett and Davina McCall.

Here are the foods you – and your partner – need to eat...
How to do it:
The first step to better fertility is to ensure you have a balanced diet and don’t cut out any major food groups. “Make sure you both get adequate protein from lean meat and fish, essential fats from fish, nuts and seeds, wholemeal carbohydrates and lots fruit and veg,” says Zita.
Once you have the basics right you can then add the specific superfoods that researchers have found can boost egg and sperm production. But be patient: you will both need to stick to a diet plan for at least three months before you will know if it has had any effect.

Here’s what you should be eating...

For him
Oily fish.This is the best source of essential fatty acids (EFAs), omega-3 and omega-6 oils – all of which are vital for sperm development. They also enhance sperm quality and mobility.* Eat: Salmon, mackerel and sardines are all types of oily fish. Men should eat between one and four portions a week.
Oysters.A great source of zinc, which is needed to make the outer layer and tail of the sperm. Nutritionists believe just 15mg a day can help repair sperm that have been damaged by chemicals absorbed from the environment.

* Eat: If you can’t stomach or afford oysters, you’ll find plenty of zinc in beans, nuts, seeds and eggs.

Garlic.This is a great source of selenium, an antioxidant, which helps maintain strong healthy sperm.* Eat: Add chopped garlic to stir-fries, pasta sauces and curries. Garlic breath may not be very romantic but it can be easily neutralised by chewing a little parsley afterwards.

Spinach.This and other leafy greens are rich in folate, which improves sperm production. A study by the University of California found men with high intakes of this nutrient had up to 30% healthier sperm.

* Eat: Steam spinach lightly with garlic and chilli or eat it raw in a healthy salad.

Avocados.A rich source of vitamin E, which improves the quality of sperm. Avocados are also an excellent way to absorb unsaturated fats, which are crucial for healthy hormone function.

* Eat: Make your own guacamole as a dip for carrot sticks. Scoop flesh out of a couple of avocados and mash it up, adding a little garlic and lemon juice.

For her
Full-fat dairy. A fertility study by Harvard University found women who eat at least one serving of full-fat dairy a day reduce their risk of infertility by more than a quarter. It’s thought that the fat in dairy helps improve ovarian function.

* Eat: Consider changing low-fat dairy foods for full-fat while you are in the process of trying for a baby. A glass of milk a day is plenty.

Water. If you don’t drink enough water the reproductive system will lose out as the body ensures that the most vital organs receive the water that they need first.Water is needed for plump egg follicles and a strong blood supply to the womb lining. If you’re dehydrated, your cervical fluid (the stuff that helps the sperm find the egg) also becomes sluggish.

* Drink: Aim to have about eight glasses per day. Try mixing water with fruit juice or a squirt of lemon to liven it up.

Orange fruit and vegetables. Peaches, apricots, carrots and mangoes all contain beta-carotene, which the body converts into vitamin A and which helps to produce the female sex hormones important for ovulation.

* Eat: Start the day with a mango and peach smoothie, and have a bag of chopped carrots to snack on at work.

Chicken.Getting enough protein is vital for egg production. Meat is the best source of protein but go for chicken rather than red meat – as it is much lower in fat.

* Eat: Women need about 45g of protein a day but don’t have more than this. As Zita West warns: “High-protein diets aren’t good in the lead-up to pregnancy, as there’s evidence that ammonia, a by-product of excessive protein, may interfere with embryo implantation.”

Oily fish, nuts and seeds.These are all extremely rich in essential fatty acids, which are crucial for healthy ovulation. According to Zita, eight out of 10 women are currently deficient in EFAs.

* Eat: You need to eat about 30g of nuts and seeds a day – enjoy them as a snack, sprinkle them on your cereal or mix into a healthy salad. Also try to eat about 300g – or roughly two portions – of oily fish a week.

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