Surgical techniques and legislative framework for female sterilization in the Czech Republic

Summary

Sterilization is a medical procedure that permanently inhibits fertility, while leaving the sexual glands intact. It is an effective and permanent means of birth control. Sterilization of a woman is done by surgical occlusion of the ovaries, thus preventing the sperm from getting in contact with the oocytes. History of surgical sterilization dates back to the beginning of 19^th century. At present, sterilization represents 33% of all possibilities for female contraception worldwide. Surgery is usually performed by abdominal laparoscopy or, less frequently, by transcervical hysteroscopy or by dorsal vaginal vault. The tube occlusion may be surgical (cutting across, tying under), electrical (bipolar/unipolar coagulation), mechanical (application of clips, rings), chemical (tissue glues). Since, at present, sterilization is usually an irreversible approach, numerous novel methods are under development, including reversible body implants. When performed in a healthy woman who already has children and wishes not to have any more children, sterilization has no physical or psychological consequences. The benefit of this method includes the continuity of menstruation and ovulation, i.e. no effect on hormonal systems. Sterilization can also reduce the risk of ovarian cancer, probably through local disturbance of the vascular circulation, thus increasing the number of anovulatory cycles.

Key words:
sterilization – history – bipolar coagulation – transcervical hysteroscopic sterilization – Pomeroy method