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You might choose sterilization, such as some surgical options for women who don’t plan to have children in their lifetimes, or who have already had all the children they plan to have. Surgery will not prevent STDs but is a highly effective method of birth control.

Two types of sterilization exist. The first is for women, called tubal ligation. Tubal ligation might be referred to as getting one’s “tubes tied.” It is the surgical process of blocking the pathway of your eggs and preventing fertilization. The process is done through laparoscopy. The fallopian tubes may be blocked by tying, clipping, blocking or cutting them or through an electric current seal. This procedure is not generally reversible, so you should be quite sure of your aversion to giving birth before you make the decision. As with all surgery, minor risks are associated with tubal ligation. A very rare chance also exists that the fallopian tubes will reopen and allow a pregnancy to occur with a greater chance of being ectopic, which is a pregnancy in the fallopian tubes or pelvis and not in the uterus. Tubal ligation is often recommended for women whose health would be seriously compromised or damaged by a pregnancy. If you are interested, you should consult with your doctor and ob/gyn.

PPH is another method of sterilization that involves filling the fallopian tube with a titanium plug to prevent the release of eggs.

The other option for sterilization, a vasectomy, is performed on men. A vasectomy is the process of cutting a man’s vas deferens so sperm cannot mix with seminal fluid. That means the tubes that carry the sperm to the penis are clamped or cut. Vasectomy is a highly effective method of preventing pregnancy, if you are in a monogamous relationship with the sterilized fellow. The procedure obviously does not prevent STDs. The possible complications associated with the vasectomy include infection near the testicles; bruising, swelling and tenderness of the scrotum; and small lumps near the testicles caused by sperm leakage.

These procedures are relatively expensive, but a vasectomy is considerably cheaper than a tubal ligation. Your insurance might cover these procedures if a serious medical risk associated with pregnancy is present. Otherwise, you’re probably on your own.

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