Synopsis
Support a voluntary, durable decision about vasectomy or female sterilisation by comparing permanent and reversible options, procedural failure, ectopic risk, recovery, clearance and future regret.
- Sterilisation is intended to be permanent. Discuss the realistic possibility that reversal will be unavailable, costly or unsuccessful and that IVF does not guarantee a live birth.
- Compare permanent methods with the implant and intrauterine contraception, which are at least as effective for many users, avoid permanent surgery and can be removed.
- Vasectomy is usually safer, simpler and more effective than laparoscopic female sterilisation, but it is not immediately effective and requires post-vasectomy semen clearance.
Key red flags
Pressure from a partner, family member, institution or clinician to accept permanent contraception undermines voluntariness and requires a private conversation and possible safeguarding support.
Investigation priorities
Confirm the person can understand, retain, use and weigh relevant information and communicate the permanent choice.
Management branches
An adult requests vasectomy or female sterilisation.
- Speak privately, presume capacity and explore reproductive goals, stability of preference, external pressure and the person’s own future-change scenarios.
- Compare vasectomy, female techniques, implant and intrauterine methods using failure, reversibility, bleeding, anaesthesia, recovery, STI and access information.
A couple or individual considering permanent contraception has access to vasectomy and it is acceptable to the person undergoing it.