(Press-News.org) (SACRAMENTO, Calif.) — The risk of pregnancy among women using a newer method of planned sterilization called hysteroscopic sterilization is more than 10 times greater over a 10-year period than using the more commonly performed laparoscopic sterilization, a study by researchers at Yale University and UC Davis has found.
Published online today in the medical journal Contraception, the study found the higher risk of pregnancy with a newer sterilization method marketed under the brand name Essure®.
"This study provides essential information for women and their doctors discussing permanent sterilization," said lead study author Aileen Gariepy, assistant professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the Yale School of Medicine.
Female surgical sterilization is the most popular method of pregnancy prevention worldwide and the most commonly used method of contraception among women age 35 and older in the United States. Each year, 345,000 U.S. women undergo sterilization procedures, and a total of 10.3 million U.S. women rely on female sterilization for pregnancy prevention.
Hysteroscopic sterilization is a multi-step process that requires women to have a procedure to place coils inside the opening of the Fallopian tubes, use another method of contraception for three months after the procedure, and then have a special X-ray test in which dye is pushed into the uterus to confirm whether the tubes are blocked.
"When Essure was first approved by the Food and Drug Administration in 2002, data presented to physicians and patients only included those women who successfully completed all of the steps to be sterilized using the procedure," said study co-author Mitchell Creinin, professor and chair of the Department of Obstetrics and Gynecology at the UC Davis School of Medicine.
"However, physicians quickly realized that at least 1 in 10 women would not be able to have the coils placed and that many would not return for follow-up testing," he said.
The study uses data in the published literature to model what happens to women who start down a path of wanting a laparoscopic sterilization or hysteroscopic sterilization, including those who do not successfully have the procedure. The computer model, called a decision analysis, calculates what could occur in a theoretical group of 100,000 women taking into account all of the potential options that could happen in each step of the process.
The authors found that pregnancy risk after hysteroscopic sterilization is primarily accrued in the first year after initiating the process because hysteroscopic sterilization is not immediately effective. Conversely, laparoscopic sterilization is immediately effective.
The major findings by Gariepy and colleagues include that pregnancy rates in the first year for women planning hysteroscopic sterilization are 57 per 1,000 women, compared with about 3 to 7 per 1,000 women for laparoscopic sterilization. The total pregnancy rate over 10 years reached 96 per 1,000 women for hysteroscopic sterilization compared to only 24 to 30 per 1,000 women with a laparoscopic procedure. The authors accounted for other methods of contraception that would be used for women who did not have a sterilization procedure, including that some women who have a failed hysteroscopic procedure would choose a laparoscopic procedure.
Since its introduction, hysteroscopic sterilization has been performed on more than 650,000 women worldwide. This newer procedure can be performed in a doctor's office and does not involve abdominal incision or general anesthesia.
Many doctors and patients think that these factors make the procedure seem easier.
"However, for women who want to be sure they don't get pregnant, the current method of hysteroscopic sterilization still is not ready to be used for everyone," Creinin said.
There have been no studies comparing the effectiveness of hysteroscopic sterilization with laparoscopic sterilization.
"This limits providers' and patients' ability to make informed decisions," Gariepy said.
Gariepy also pointed out that unintended pregnancy resulting from sterilization failure can have serious consequences for both women's quality of life and maternal and neonatal health outcomes, and should be considered a significant adverse event.
"Women choose sterilization specifically to prevent any future pregnancies," Gariepy said. "If one sterilization method has a much higher risk of pregnancy, women and their doctors need to know that as they consider the overall risks and benefits of the procedure."
INFORMATION:
Other study authors include Xiao Xu of Yale and Kenneth Smith of the University of Pittsburgh.
The study was supported by a grant from the Society of Family Planning.
The UC Davis School of Medicine is among the nation's leading medical schools, recognized for its research and primary-care programs. The school offers fully accredited master's degree programs in public health and in informatics, and its combined M.D.-Ph.D. program is training the next generation of physician-scientists to conduct high-impact research and translate discoveries into better clinical care. Along with being a recognized leader in medical research, the school is committed to serving underserved communities and advancing rural health. For more information, visit UC Davis School of Medicine at http://medschool.ucdavis.edu.
Risk of pregnancy greater with newer method of female sterilization
2014-04-22
ELSE PRESS RELEASES FROM THIS DATE:
PETA science consortium to present hazard testing strategy at nanotoxicology meeting
2014-04-22
London – PETA International Science Consortium Ltd.'s nanotechnology expert will present a poster titled "A tiered-testing strategy for nanomaterial hazard assessment" at the 7th International Nanotoxicology Congress to be held April 23-26, 2014, in Antalya, Turkey.
Dr. Monita Sharma will outline a strategy consistent with the 2007 report from the US National Academy of Sciences, "Toxicity Testing in the 21st Century: A Vision and a Strategy," which recommends use of non-animal methods involving human cells and cell lines for mechanistic pathway–based toxicity studies. ...
Nanoreporters tell 'sour' oil from 'sweet'
2014-04-22
Scientists at Rice University have created a nanoscale detector that checks for and reports on the presence of hydrogen sulfide in crude oil and natural gas while they're still in the ground.
The nanoreporter is based on nanometer-sized carbon material developed by a consortium of Rice labs led by chemist James Tour and is the subject of a new paper published this month in the American Chemical Society journal ACS Applied Materials and Interfaces.
Limited exposure to hydrogen sulfide causes sore throats, shortness of breath and dizziness, according to the researchers. ...
New research focuses on streamwater chemistry, landscape variation
2014-04-22
MISSOULA – Winsor Lowe, interim director of the University of Montana's Wildlife Biology Program, co-wrote a research paper published April 21 in the Proceedings of the National Academy of Sciences on how streamwater chemistry varies across a headwater stream network.
Lowe and co-authors from Virginia Tech, the U.S. Geological Survey, the University of Washington, the Cary Institute of Ecosystem Studies, the University of Connecticut and the U.S. Forest Service Northern Research Station examined 664 water samples collected every 10 meters along 32 tributaries ...
Online retailers have clear advantage by not collecting sales tax
2014-04-22
COLUMBUS, Ohio – Two independent studies use two very different approaches to reach the same conclusion: some online retailers really do have an advantage over traditional brick-and-mortar stores.
The studies find evidence from investors, analysts and consumers themselves that suggest online stores have a competitive edge when they don't have to collect sales tax from shoppers.
Both studies were conducted by researchers at the Fisher College of Business at The Ohio State University and their colleagues.
In one study, Brian Baugh, Itzhak Ben-David, and Hoonsuk Park ...
Scientists identify critical new protein complex involved in learning and memory
2014-04-22
JUPITER, FL, April 22, 2014 – Scientists from the Florida campus of The Scripps Research Institute (TSRI) have identified a protein complex that plays a critical but previously unknown role in learning and memory formation.
The study, which showed a novel role for a protein known as RGS7, was published April 22, 2014 in the journal eLife, a publisher supported by the Howard Hughes Medical Institute, the Max Planck Society and the Wellcome Trust.
"This is a critical building block that regulates a fundamental process—memory," said Kirill Martemyanov, a TSRI associate ...
Almost one-third of Canadian adults have experienced child abuse
2014-04-22
Almost one-third of adults in Canada have experienced child abuse — physical abuse, sexual abuse or exposure to intimate partner (parents, step-parents or guardians) violence in their home. As well, child abuse is linked to mental disorders and suicidal ideation (thoughts) or suicide attempts, found an article published in CMAJ (Canadian Medical Association Journal).
"From a public health standpoint, these findings highlight the urgent need to make prevention of child abuse a priority in Canada," writes Dr. Tracie Afifi, departments of Community Health Sciences and Psychiatry, ...
Multiple sclerosis: A review of current treatments for physicians
2014-04-22
A review of the literature on treating multiple sclerosis (MS) aims to provide physicians with evidence-based information on the latest treatments for this chronic disease. The article, published in CMAJ (Canadian Medical Association Journal) looks at the latest pharmacologic research as well as disease-modifying agents and the benefits and risks of various treatments.
"Recently, several new compounds have been developed and approved with the aim of favourably changing the disease course, but with varied success," writes Dr. Loredana La Mantia, Cochrane Multiple Sclerosis ...
Neuroimaging: Live from inside the cell
2014-04-22
This news release is available in German.
Reactive oxygen species are important intracellular signaling molecules, but their mode of action is complex: In low concentrations they regulate key aspects of cellular function and behavior, while at high concentrations they can cause "oxidative stress", which damages organelles, membranes and DNA. To analyze how redox signaling unfolds in single cells and organelles in real-time, an innovative optical microscopy technique has been developed jointly by the teams of LMU Professor Martin Kerschensteiner and TUM Professor ...
Research shows impact of Facebook unfriending
2014-04-22
DENVER (April 22, 2014) – Two studies from the University of Colorado Denver are shedding new light on the most common type of `friend' to be unfriended on Facebook and their emotional responses to it.
The studies, published earlier this year, show that the most likely person to be unfriended is a high school acquaintance.
"The most common reason for unfriending someone from high school is that the person posted polarizing comments often about religion or politics," said Christopher Sibona, a doctoral student in the Computer Science and Information Systems program at ...
AMP publishes curriculum recommendations for medical laboratory scientists
2014-04-22
Bethesda, MD, April 22, 2014: The Association for Molecular Pathology (AMP) released a report today in The Journal of Molecular Diagnostics on recommendations for a molecular diagnostics curriculum at both the baccalaureate and master's levels of education. The report was prepared by the Medical Laboratory Scientist (MLS) Curriculum Task Force of the AMP Training and Education Committee. "Our goal was to address the critical need of educating future medical laboratory scientists appropriately in order to manage the rapidly growing and changing realm of molecular diagnostic ...