Selective tubal occlusion procedure (STOP) is a nonsurgical form of permanent birth control in which a physician inserts a 4-centimeter (1.6 inch) long metal coil into each one of a woman’s two Fallopian tubes via a scope passed through the cervix into the uterus and from there into the openings of the Fallopian tubes. Over the next few months, tissue grows over the coil to form a plug that prevents fertilized eggs from traveling from the ovaries to the uterus.

STOP takes 15 to 30 minutes, can be done in a doctor’s office, and usually requires only a local anesthetic.

During a 3-month period after the coils are inserted, women must use other forms of birth control until their physician verifies by X-ray that the Fallopian tubes are completely blocked.

STOP is permanent (not reversible) and is designed as an alternative to surgical sterilization which requires general anesthesia and an incision. About 6% of women who have had STOP have side effects, mainly due to improper placement of the coils.

Tubal occlusion (blockage) has been effective at 3 months in 96% of women undergoing STOP, and at 6 months in 100%. Long-term success is not verified yet, as the procedure was only recently approved in the U.S.

STOP does not protect a woman or her partner from sexually transmitted infections (sexually transmitted diseases, or STDs).

Hysterectomy

A hysterectomy is the surgical removal of a woman’s uterus and, depending on her overall health status, perhaps her ovaries as well. No woman who has had a hysterectomy can become pregnant; it is an irreversible method of birth control and absolute sterilization.

If a woman has other chronic medical problems that may be helped by a hysterectomy, than this may be an appropriate procedure for her to consider. Otherwise, contraception should be considered a secondary benefit and not a reason to have the procedure in the first place. For more, please read the Hysterectomy article.

Summary and Conclusions

Many methods of birth control and contraception are available today. There are many options. Unfortunately, most of these choices offer little or no protection against sexually transmitted infections (sexually transmitted

diseases, or STDs), especially against HIV, the human immunodeficiency virus that causes AIDS. This is a critical warning that cannot be made too often.

For some individuals, economic considerations dictate their choice of contraceptive method. Abstinence is 100% effective and costs nothing, but may not always be a popular choice. “Natural” methods cost essentially nothing (if one does not use test kits or electronic monitors) but they require considerable discipline to be effective. Barrier methods, such as spermicides and condoms, are affordable to most people and can be effective if they are used consistently and correctly. The hormonal methods, such as “the pill,” are highly effective but their cost can add up if they must be purchased and regularly repeated.

The choice of a particular method of contraceptive also depends on a person’s age, health, and personal situation. For example, behavioral methods (fertility awareness or withdrawal), IUDs, and tubal ligation are not methods recommended for teenagers. A vasectomy or tubal ligation are not appropriate for a man or woman who wishes to have children in the future because surgical reversal is not guaranteed. Certain medical conditions can rule out a woman using a hormone-based method of birth control.

The method a person chooses to control their sexual reproduction is a personal issue. The choice of a contraceptive method should ideally be made by both the man and the woman with the assistance of their health care professionals.

Birth Control At A Glance

 
• Methods of birth control include barrier, mechanical, hormonal, and natural methods, as well as emergency and permanent methods.  
• All methods of birth control are based on either preventing a man’s sperm from reaching and entering a woman’s egg (fertilization) or preventing the fertilized egg from implanting in the woman’s uterus (her womb) and starting to grow.  
• No birth control method, except abstinence, is considered to be 100% effective.  
• No method of birth control available today offers perfect protection against sexually transmitted infections (sexually transmitted diseases, or STDs), except abstinence.

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SOURCE: Archives of Pediatrics & Adolescent Medicine