In order to prevent pregnancy, many couples turn to contraceptive pills, creams and barriers. These methods vary in the mechanism by which they prevent pregnancy---some involve killing sperm, while others prevent the sperm from reaching the egg. Still others preclude implantation. Some couples, however, prefer alternatives to contraceptive drugs and devices, either because they feel more comfortable with a natural approach to pregnancy prevention or because they dislike the thought of preventing the implantation of a fertilized egg.
Vasectomy
A vasectomy is a semi-surgical, permanent procedure performed in a doctor's office. The American Academy of Family Physicians (AAFP) describes the procedure as a relatively short one, typically lasting only half an hour and performed on a conscious patient. The skin near the scrotum is numbed using a shot of local anesthetic, then the physician makes a small incision on each side of the scrotum. The vas deferens, or tube through which sperm travels from the testes into the urethra, is partially extruded through the small hole. The doctor the cuts the vas deferens and ties off the ends, sealing them and preventing the ejaculation of sperm---this is done on both sides. A study published in 2000 in the scientific journal "Fertility and Sterility" reports that vasectomies are quite safe, with minor post-procedural complications occurring in 1 to 6 percent of men. The AAFP reports the effectiveness of the procedure at around 99.85 percent.
Tubal Ligation
Tubal ligation is a surgical sterilization procedure for women. According to the AAFP, the surgery may take place under anything from local to full anesthesia. During the surgery the fallopian tubes, through which an egg travels from the ovary to the uterus, are cut and tied off. While tubal ligation is a bit more invasive than male sterilization, most women recover completely within a few days, and are back to normal activity within a week. The procedure does not affect menstruation, which proceeds as normal each month, nor does it protect against sexually transmitted infection, but it is highly effective at preventing pregnancy, with a success rate of nearly 100 percent.
Coitus Interruptus
The National Institutes of Health (NIH) defines coitus interruptus as a pregnancy prevention technique in which the penis is removed from the vagina before ejaculation occurs. Theoretically, this method of pregnancy prevention should prevent semen from entering the vagina, passing through the cervix, and fertilizing an egg. The NIH cautions, however, that pre-ejaculate material often contains sperm, and that semen can escape the penis prior to true ejaculation. These factors combine to make coitus interruptus a bit less reliable than other non-contraceptive pregnancy prevention methods.
Natural Family Planning
Also referred to as the "rhythm method," natural family planning involves tracking a woman's reproductive cycle and avoiding sexual relations during fertile periods, according to the NIH. They suggest that cervical mucus and basal body temperature both change in response to hormonal fluctuations. Further, a woman who experiences regular menstrual periods can often use her flow dates to predict ovulation. The NIH recommends abstaining from sex for several days on either side of ovulation, as both sperm and egg can survive in the woman's body for some time after they are released. Natural family planning techniques are generally 15 to 20 percent effective, according to the NIH.
References
- "Fertility and Sterility"; Safety and effectiveness of vasectomy; Pamela J. Schwingl Ph.D. and Harry A. Guess M.D.; May 2000
- AAFP: Vasectomy Procedure and Effectiveness
- AAFP: Tubal Ligation Procedure and Effectiveness
- NIH: Contraceptive Alternatives
- Planned Parenthood: Natural Family Planning
