Commentary| Volume 77, ISSUE 1, P6-9, January 2008

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Intrauterine contraception as an alternative to interval tubal sterilization

      In countries where levonorgestrel-releasing IUD use has increased, the incidence of female surgical sterilization procedures has decreased [
      • Inki P.
      Long-term use of the levonorgestrel-releasing intrauterine system.
      • Mansour D.
      Copper IUD and LNG IUS compared with tubal occlusion.
      ]. Will the same inverse relationship appear in the United States, and, if so, what would be the medical implications of such a transition in long-term contraception? A recent UK review compared long-term contraception with IUDs vs. surgical sterilization [
      • Mansour D.
      Copper IUD and LNG IUS compared with tubal occlusion.
      ]; here we compare these two approaches from a US perspective. We focus on interval tubal sterilization by laparoscopy or laparotomy and will not consider postpartum sterilization.
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      Linked Article

      • Re: Intrauterine contraception as an alternative to interval tubal sterilization
        ContraceptionVol. 78Issue 1
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          We read with interest the article by Grimes and Mishell [1] on intrauterine contraceptive devices (IUD) and tubal sterilization. They elaborate on the usefulness of IUD compared to interval tubal sterilization. However, there are some issues that need further consideration. The cost of IUD, especially the cost of levenogestrel-releasing IUD (LNG-IUS), should gather the most speculation. It is important to analyze 5-year cost of contraceptives and their effectiveness and choose the least expensive methods.
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