EVOLVING TRENDS IN FEMALE STERILIZATION: A REVIEW ARTICLE

Background: Globally, tubal sterilization is the most commonly used method for permanent contraception. In developed countries were awareness is widespread and resources for purchase, maintenance and available trained manpower exist, laparoscopy rather than mini-laparotomy is the method of choice for tubal ligation. In developing countries, especially in underdeveloped countries where poverty is rampant, resources unavailable or limited for purchase or maintenance of these sophisticated laparoscopic equipment, with largely untrained manpower in the art of laparoscopy, mini-laparotomy is still the most common method of tubal ligation. Objectives: To search the reasons for the evolving trends in tubal sterilization worldwide and the challenges each method poses to enable us seek for safer, easier and cost effective methods of sterilization in the nearest future. Methods: An electronic search of Medline, Embase, Cochrane database systematic review was performed. All randomized controlled trials comparing different techniques of tubal ligation and other relevant articles and review on tubal sterilization from 1973 to 2014 were included in the review according to availability. Conclusion: Major morbidity seems to be a rare phenomenon in tubal sterilization regardless of the method of tubal sterilization employed. While tubal sterilization is still the most widely used form of contraception worldwide especially in developed countries the same cannot be said of developing countries were the uptake rates remain very low. Availability of endoscopic equipment, skilled manpower, adequate counseling and education will ultimately improve uptake rates in developing countries. In future, the ideal female sterilization should be simple, safe, highly efficient, easily learned, inexpensive, easily reversible and a onetime procedure without negative side effects Keywords: