Vasectomy makes the cut with men who are married
Vasectomy makes the cut with men who are married
A just-published analysis of national data reveals that one in eight married men report having a vasectomy.1
Vasectomy, or male sterilization, is one of the safest and most effective family methods, according to Contraceptive Technology.2 The first-year failure rate in the United States is estimated at 0.15%, with a range of 0% to 0.5%.2 Failure rates are believed to be similar to those for female sterilization and lower than those for reversible methods.2
To perform the analysis, researchers estimated the prevalence of vasectomy and tubal ligation of partners for male participants in the 2002 National Survey of Family Growth, a nationally representative survey that looks at residents ages 15-44. The scientific team identified factors associated with sterilizations using bivariate and multivariate techniques.
Men who rely on vasectomies have a somewhat different profile than those whose partners have had tubal sterilizations, researchers report. Data indicate that use of vasectomy increased with older age and greater number of biological children, non-Hispanic white ethnicity, and having ever gone to a family planning clinic. Tubal sterilization use was more likely among men who had not attended college, those of older age, and those with live births.
What's next in research pipeline
What are the next steps in research regarding vasectomy use? Investigators are conducting similar analyses of vasectomy use using the recently released National Survey of Family Growth data for 2006-2008, based on the same questionnaire items, says John Anderson, PhD, a research scientist in the Women's Health and Fertility Branch, Division of Reproductive Health, at the Centers for Disease Control and Prevention in Atlanta.
While the United States ranks in the global top 10 countries when it comes to vasectomies, six countries (United Kingdom, New Zealand, Bhutan, Netherlands, Denmark, and Austria) report method use that equals or exceeds use of female sterilization.3
Clinicians need to present vasectomy at every option and be strongly encouraging of its safety and efficacy, says David Turok, MD, assistant clinical professor in the Department of Obstetrics and Gynecology at the University of Utah in Salt Lake City. Turok along with Willie Parker, MD, medical director of Planned Parenthood of Metropolitan Washington, DC, and Grace Shih, MD, a fellow in the Department of Family and Community Medicine at the University of California, San Francisco, presented information on vasectomy techniques at the recent 2010 Reproductive Health conference.4 The conference was sponsored by the Association of Reproductive Health Professionals, Planned Parenthood Federation of America National Medical Committee, and the Society of Family Planning.
While sterilization is the most common method of contraception in the United States, two-thirds of all sterilizations are performed in women, despite the fact that vasectomy is safer, cheaper, and more effective, says Turok. This discrepancy is even more exaggerated in communities of color. For example, African-American women have a sterilization rate of 22%, but for men, the rate is 1%, says Turok. Turok, Parker, and Shih are collaborating on an upcoming vasectomy review article and editorial in the journal Contraception to focus on such facts. All three have incorporated vasectomy into their practices.
"It will certainly take time to reverse the well-established trend of female-dominated sterilization, but with a concerted effort to address provider and patient issues regarding acceptance and availability, it can be done," says Turok.
No-scalpel vasectomy is easy to learn with supervision, and more family planning providers should be encouraged to do so, including traditional women's health care providers, says Turok. Practitioners who provide reproductive health care also should have a referral network within their community for vasectomy services, he notes.
Turok works with Central City Community Health Center in Salt Lake City, which provides care for a predominantly Hispanic population. Vasectomy has been offered at the facility for more than a decade, Turok reports. It has been warmly received, he says, with hundreds of procedures performed.
"Our population is uninsured, and this is a self-pay procedure. Our local Planned Parenthood does the same," says Turok. "This is a great service to offer our patients."
References
- Anderson JE, Warner L, Jamieson DJ, et al. Contraceptive sterilization use among married men in the United States: results from the male sample of the National Survey of Family Growth. Contraception 2010; 82:230-235.
- Pollack AE, Thomas LJ, Barone MA. Female and male sterilization. In: Hatcher RA, Trussell J, Nelson AL, et al. Contraceptive Technology: 19th revised edition. New York: Ardent Media; 2007; 380.
- United Nations, Department of Economic and Social Affairs, Population Division. World Contraceptive Use, 2007. Wall chart. Available at http://www.un.org/esa/population/publications/contraceptive2007/WallChart_WCU2007_Data.xls.
- Parker W, Shih G, Turok D. Vasectomy: The No-Scalpel Technique and Occlusion Methods. Presented at the 2010 Reproductive Health Conference. Atlanta; September 2010.
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