Tubal ligation is no better than an IUD at preventing pregnancy, study shows

The analysis, based on six years of California Medicare claims data, is the first rigorous look at how long-term contraception works in the real world

The study overturns the widely held assumption that tubal ligation is more effective than the IUD

The study, published February 22, 2022 in the Journal of General Internal Medicine, found that hormonal IUDs were more effective at preventing pregnancy than tubal ligation, while copper IUDs were equally valid

"Tubal ligation is really no longer the gold standard for preventing pregnancy," said Eleanor Bimra Schwartz, MD, professor of medicine at UCSF and chief of the Division of Internal Medicine at Zuckerberg San Francisco General Hospital

The researchers looked at claims data from more than 83,000 patients who received a tubal ligation or an IUD between 2008 and 2014 with Medicare in California to see how many became pregnant within a year

"Women were told the odds of getting pregnant using these contraceptives were one in 1,000, but we found that the odds were much higher," Schwartz said

The study also found that women who received the IUD were less likely to have infections or complications from surgery, and that after six months, women who received the IUD were less likely to develop pelvic, abdominal, and Genitourinary pain is less likely

The relatively high failure rate of tubal ligation procedures and the prevalence of persistent pelvic pain both surprised the researchers, who conducted the study on the advice of a patient advisory group

"Our stakeholders want to know, 'How safe and effective are permanent contraceptive procedures when women have them?'" Schwartz said

These are good questions, and Schwartz said doctors and patients alike should pay attention to the answers to them

"Tubal ligations are permanent," Schwartz said.

Because IUDs offer at least the same level of protection against unwanted pregnancy as surgery, Schwartz said, "patients should be encouraged to try IUDs before entering the operating room for permanent surgery

Journal Reference :

1. Eleanor Bimla Schwarz, Carrie A.