1. Contraception
Potpourri

2. Sterilization

3. Sterilization: Vasectomy
Vasectomy blocks sperm from traveling through the vas deferens, preventing sperm from mixing into semen
No glands or organs are removed
Effectiveness: 99%+
Considered irreversible

4. Sterilization: Vasectomy
Vas deferens must be isolated
Similar to tubal ligation, the vas deferens can be cut and tied, clamped, cauterized, no scalpel technique
Another form of contraception must be used for a few months

5. Sterilization: Vasectomy
Cost: $ (plannedparenthood.org)
Side effects
Bruising
Sensitivity/pain for up to a few weeks past the procedure
Sperm leaking from tubes may lead to small lump (usually clears up on its own)
Antibodies to sperm may develop, reducing chances of fertility in a reversal

6. Vasectomy Complications
Rare
Usually associated with infection (fever, pus/blood from incision site, swelling, pain)
Ends of tubes may grow back together (very rare)
Decreased sexual desire (4 out of 1000 cases per Planned Parenthood) - no apparent physical cause

7. Sterilization: Vasectomy
Animation (BUPA Health via YouTube, 2:36)
Open-ended (no scalpel) vasectomy (medicalvideos.us)
Video (vasectomymedical.com)

8. Sterilization: Tubal Ligation
Surgical technique
Close fallopian tubes, preventing egg from traveling to uterus, preventing sperm from reaching egg
Neither organs nor glands are removed
Effectiveness: 99%+
Considered irreversible

9. Sterilization: Tubal Ligation
Tubal sterilization:
Tubes can be tied and cut (Pomeroy technique)
Tubes can be cauterized
Tubes can be clipped, clamped
These incision methods often performed after childbirth/abortion
Animation (SMART imagebase)

10. Sterilization: Tubal Ligation
Cost: $
Side effects: thought by many to be rare; hormonal imbalance may lead to increased menstrual bleeding, cramping; adhesions
Complications: infection, internal bleeding, ectopic pregnancy
Before/after photos (private Flickr account)

11. Sterilization: Implants
Non-incision method
No general anesthesia
Under an hour
Coils inserted into fallopian tubes
In following months, coils and tissue grow together, forming barrier to prevent sperm from reaching egg

12. Sterilization: Implants
Side effects: expulsion of coil inserts, risk for ectopic pregnancy, cramping, menstrual changes, nausea/vomiting
Demo (YouTube, 1:04)

13. Long-Term Contraception & Sterilization: Project Prevention
Societal aid or eugenics?
FOX News program (1:30 minutes)
ABC News program (2:19 minutes)

14. Contraception in the Future: Nestorone
Estrogen and progestin
Gel
Spray
Acrux Announcement, February 2009
Figure 2: Estrogen content in Nestorone, OrthoEvra, NuvaRing, combination pills
2012: Combination of nestorone and testosterone reduced sperm count in UCLA study

15. Contraception: The Future
Male hormonal contraceptive: monthly testosterone injection
5/ 2009: China clinical trials
1 in 100 fathered a child
Reversible six months after stopping injections
1/3 of 1000 participants did not complete; no reason provided
Few side effects reported (acne, weight gain), but more research needed
Contraceptive methods may work better in Asian men vs European men
Photo from BBC

16. Contraception: The Future
RISUG
Reversible Inhibition of Sperm Under Guidance
Contraceptive method for men
Clinical trials in India
Injection into vas deferens of male (video, wired.com, :34)
RISUG disrupts membranes of sperm so they cannot fertilize
One injection to last 10 years
Reversibility not well tested, though reports on primates appear positive (requires another injection)
Marketing challenges

17. Contraception: The Future
Male contraceptive pill research at UW (KOMO report, 2009, 2:10, YouTube)
Non-hormonal manipulation of sperm production has been successful in mice (2012)
Vitamin A blocking can reduce fertility (but Vitamin A needed for other bodily functions)

18. Contraception: The Past
Male Contraceptive: Heat
Prolonged heat exposure can impair sperm production in testes
Ancient method
Effectiveness?
116 degree bath
45 minutes
Every day
Three weeks

19. Contraception: Impact of Heat on Sperm

20. Contraception: Impact of Heat on Sperm
Dada, R, Gupta, NP, & K. Kucheria. Deterioration of Sperm Morphology in Men Exposed to High Temperature. Journal of the Anatomical Society of India.
Vol. 50, No. 2 ( )

21. Contraception: Impact of Heat on Sperm
Upper left: coiled tail
Upper right: bent tail
Lower left: double head
Lower right: triple head
Dada, R, Gupta, NP, & K. Kucheria. Deterioration of Sperm Morphology in Men Exposed to High Temperature. Journal of the Anatomical Society of India. Vol. 50, No. 2 ( )

22. Temperature Method Track temperature every morning
Look for slight drop in temperature occurring immediately before ovulation
At ovulation, temperature increases
Temperature changes are small
Look for trends, expect daily fluctuations
Image source: Public domain, Wikimedia Commons

23. Temperature Method Use basal thermometer
Smaller scale (1/10 degree)
Chart temperature for at least three months before relying on method
Safe sex time begins 72 hours after temperature has risen, remains until temperature begins to drop
Source: Dr. Sacha Elliott, ND

24. Temperature Method Day 10: 98.5 Day 17: 98.8 Day 11: 98.4 Day 18: 99.0

25. Cervical Mucus Method
Tracking the variation in mucus consistency throughout cycle
Cervical mucus begins a few days after menstruation
As mucus production increases, it’s yellow or white in color & cloudy, sticky
Will become wet, clear
Clear, slippery mucus = most fertile
Mucus production decreases, cloudy & sticky

26. Cervical Mucus Method Tracking Your Cervical Mucus, Babycenter.com
“Safe days” = begin after slippery mucus decreases, continue into cloudy & tacky, and especially dry days
Short cycles = mucus may be hidden in menstrual flow

27. Calendar Method
Predicting “safe” and “unsafe” days based on length of monthly cycles
Can use traditional calendar, software, phone app, web tools

28. Calendar Method Count length of menstrual cycle
Day #1 = first day of menses
Last day = day before menses returns
Eight cycles are recommended before relying on this method (Planned Parenthood)
First fertile day = shortest cycle minus 18
Last fertile day = longest cycle minus 11

29. Calendar Method Cycle 1: 24 Cycle 2: 27 Cycle 3: 25 Cycle 4: 28
Shortest day: 24
Longest day: 29
Unsafe days: #6-18

30. Calendar Method Online calendar method tool - virtualmedicalcentre.com
Irregular period cycles = reduced effectiveness
Calendar method = requires another method for most to experience adequate effectiveness

31. United Nations: Contraceptive Prevalence Across the World, 2005