Update on female sterilisation: report from an international symposium on considerations for assessing long-term failure rates.

The 6th International Scientific Meeting of the Royal College of Obstetricians and Gynaecologists (RCOG) took place in September 2005 in Cairo, Egypt. During the meeting, a sponsored symposium entitled ‘The changing face of female sterilisation: meeting the needs of the 21st century woman’ (sponsored by Femcare-Nikomed Ltd, manufacturer of the Filshie clip) provided an overview of the different methods of long-term contraception with a focus on female sterilisation. Here we report the main observations of the symposium, including recommendations for factors that should be considered when assessing the long-term failure rates associated with female sterilisation. Over the past few decades, rapid advances in technology have allowed the development of a number of different contraceptive methods that are available for use today. The choice of contraception is influenced by a number of factors, including age, sexual lifestyle, relationship type, family status and medical history. In addition, as part of the necessary counselling of any family planning programme, it is essential that provision of unbiased accurate information be provided so that women can make informed decisions on long-term contraception. Long-acting reversible contraception (LARC) methods include intrauterine devices (IUDs), the progestogen intrauterine hormone releasing system (IUS), and progestogen-only injectables and subdermal implants. In the UK, a recent National Institute for Health and Clinical Excellence (NICE)1 analysis compared the efficacy of these contraceptive methods, the findings of which showed high efficacy across all these procedures (IUD failure rate <2% at 5 years; IUS failure rate <1% at 5 years; injectables <4/1000 over 2 years; subdermal implants 1/1000 at 3 years). These efficacies are superior to those of the two most common contraceptives used in the UK, namely hormonal oral contraception (combined and progestogen only, 50/1000 in the first year with typical use) and the Update on female sterilisation: report from an international symposium on considerations for assessing long-term failure rates