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Obstetrics & Gynecology 2003;101:677-684
© 2003 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Sterilization Failure, Sterilization Reversal, and Pregnancy After Sterilization Reversal in Quebec

James Trussell, PhD, Édith Guilbert, MD, MSC and Allison Hedley, PhD

From the Office of Population Research, Princeton University, Princeton, New Jersey; National Institute of Public Health of Quebec, Quebec City, Quebec, Canada; and Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada.

Address reprint requests to: James Trussell, PhD, Professor of Economics and Public Affairs and Director, Office of Population Research, Wallace Hall, Princeton University, Princeton, NJ 08544; E-mail: trussell{at}princeton.edu.

OBJECTIVE: 1) To determine the likelihood of sterilization reversal and of subsequent sterilization after sterilization reversal among men and women and 2) to examine the likelihood of pregnancy after sterilization (contraceptive failure) and of pregnancy after sterilization reversal.

METHODS: Payment data from the Quebec provincial health insurance system were obtained for each person undergoing vasectomy or female sterilization from January 1, 1980 to December 31, 1999 and linked through a unique identifying number for each person. Using standard techniques of survival analysis, we computed the cumulative probability of experiencing each of six events.

RESULTS: Among women, 0.9% (of 311,960) experienced a pregnancy after sterilization, 1.8% (of 321,929) obtained a reversal after sterilization, 61% (of 4369) achieved a pregnancy after sterilization reversal and 48% achieved a delivery; 23% (of 4677) obtained a subsequent sterilization after reversal. Among men, 2.4% (of 310,827) obtained a reversal after vasectomy and 18% (of 6694) obtained a subsequent vasectomy after reversal. All of these risks were much higher among those in the youngest age groups.

CONCLUSION: Sterilization reversal and pregnancy after sterilization are not rare. Relatively high rates of reversal among the youngest age groups suggest a need for better counseling about alternative contraceptive strategies




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