Voluntary sterilization

Voluntary sterilization is discussed in the light of new legal and medical developments and the guidelines of the American Public Health Association. Voluntary sterilization is legal in all 50 states, and a Presidential commission has recommended elimination of all barriers preventing access to sterilization. The Association of Voluntary Sterilization estimates that 550,000 vasectomies were performed in the United States in 1970, and new techniques of female sterilization are making the procedure increasingly safe. The position of the APHA is that sterilization is safe and effective, does not interfere with sexual pleasure, is generally irreversible, and should always be voluntary. The viability of frozen sperm later thawed for artificial insemination has been challenged by several researchers, with one study finding a successful fertilization rate of 42.6% in artificial insemination cases using frozen semen, compared with 69% for fresh semen. Various methods are being investigated to achieve a reversible vasectomy by plugging and unplugging the vas deferens. Laparoscopic tubal division for female sterilization is a new development that appears to be relatively simple and quite safe. The hospital stay is significantly decreased with this procedure. The pregnancy failure rate is about 1%, and the complication rate is about 4-5%.