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The author, Dr. Donald Snyder, performs both vasectomy and Essure Tubal Ligation.

Vasectomy verses Tubals Part IV

Comparing Time for Determining Success: Vasectomy verses Tubal

Whether undergoing either of vasectomy, traditional tubal, Essure or Adriana how much time is required to determine success?

After a vasectomy, the man is not sterile until the sperm clears from the semen. The time after the surgery till the testing time, is a minimum period of 3 months. A semen analysis will determine if the vas tubes are clear, after-which he may rely on his vasectomy the rest of his life. If the semen analysis never clears, it is considered a failed vasectomy, and he will need to have the procedure repeated or rely on another form of birth control.
For more detail see: Confirming Sterility

For tubal ligation the sterilization effects of the "tubal" are immediate. There is no wait time and no follow-up test that is recommended. So it is just assumed the procedure was successful. This is probably the one advantage that patients have over Essure™ and vasectomy birth control methods. The only way to find out whether the tubal ligation procedure has failed is if an unwanted pregnancy occurs, sometimes many years later.

For those women who undergo the Essure™ and Adiana™ (Adiana is not available since April 2012) placement success is 95% likely, but if devices cannot be placed, other methods, including traditional tubal, may need to be relied upon. If placement is successful, there is a 3 month waiting period before the woman may rely on birth control for the rest of her life. An X-ray is taken 3 months after placement to prove the tubes have been successfully blocked. If the X-ray shows the tubes have remained open, even after additional time has passed, then the procedure cannot be relied on, and another form of birth control (possibly a laparoscopic tubal) must be used. For Essure, the failure rate is 0.1% when the tubes are blocked after being determined successful by X-ray. Adiana failure rate is 1.1% at one year and 1.8% at 2 years, even when tubes appear to be blocked, which is similar to the failure rate of traditional tubal ligation.

Comparing Cost: Vasectomy verses Tubals

Vasectomy cost is, by far, a much lower birth control alternative as compared to female sterilization. Average fees charged are $350 to $1000, depending on the location in the U.S. or Canada. Additionally health insurance plans in the US and the Canadian provincial health plans almost always cover this service. Sometimes, patients may need to pay some of the cost because of co-insurance and co-pays (in the USA) or because of extras chosen by the patient. However, since vasectomy is performed in-office, under local anesthesia by the vasectomy doctor, there are usually no additional charges, except possibly for the semen analysis, which many doctors include in the charge for the vasectomy anyway.

For more:
Vasectomy cost
No-scalpel vasectomy cost
FAQ: How much does a vasectomy cost?

Conventional Tubal ligation is expensive because of the required use of a surgical suite and anesthesia, etc. Generally the total charges in the U.S. are close to $10,000, while the amount your insurance company pays may be lower based on a contractual allowance. Public insurance usually covers the cost completely, but while most private insurance policies do cover the procedure, an individual's out-of-pocket expense varies widely. Usually the yearly out-of-pocket maximum for policy is reached when having a tubal, so you need to check the details of your policy to get an idea of what your cost may be. A common out of pocket max is $5000 for employer based private insurance plans in the U.S.

Essure™ (and Adiana™) will cost about $4,000 when performed in the doctor's office. These procedures are also covered by insurance usually. Because insurance companies often favor in-office procedures due to lower cost, it is common to only owe an office copayment as an out-of-pocket expense. Some doctors still perform these newer permanent birth control procedures for women at a hospital, which raises the cost, equal or higher than a tubal ligation. Again you will need to check your plan, and also the practice providing the service to get an accurate out-of-pocket estimate for you based on your coverage. There is also an extra expense (usually about $500) for the x-ray required 3 months after the Essure™ or Adiana™ that, although usually covered, may also incur an expense for you. Adiana is no longer available as of April 2012.

Note: In 2013 the new Accountable Care Act (Obamacare) comes into effect. As proposed, female birth control will be fully covered. Whether or how this will apply to permanent birth control such as Essure, tubal ligation and vasectomy, remains to be seen.

Tubal Ligation verses Vasectomy - Contents

About the decision: tubal ligations vs. vasectomy
Shared considerations, pros and cons, advantages and disadvantages

Comparing complications
Comparing the recovery period

Comparing effectiveness
Comparing regret and reversal

Comparing the waiting period
Comparing cost

Tubal v. Vasectomy Summary
About the author, Dr. Donald Snyder

Article Source
With appreciation, this article has been written and submitted by Dr. Donald Snyder, a prominent vasectomy provider in the Indianapolis, Indiana area. He offers his patients no-needle, no-scalpel vasectomy.
Learn about his vasectomy practice.
Learn more about Donald Snyder

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