1-Coitus interruptus
Coitus interruptus is ejaculation outside the
vagina at the end of a normal vaginal intercourse.
Despite its simplicity, coitus interruptus requires
dexterity and self-discipline,
reduces
sexual pleasure and has a failure rate of
upto 18%
2-Periodic Abstinence
This is when sex is practiced only at specific
periods of every month when pregnancy is least likely to occur:
limits
sexual activity to so-called “safe days”.
Those days are the ones immediately after arrest
of menstrual blood. 13 days abstinence (no sexual activity) are
required on average.
The
methods’ safety increases with the number of days of abstinence from
intercourse.
Unfortunately, this method is highly inaccurate
and pregnancy may occur in 20% of couples.
3-Condoms
History:
Early
Egyptian drawings show men wearing condoms. In 1200 BC fish
bladders were used at the Minoan court to prevent disease and
pregnancies. In 1564 the Italian anatomist Fallopio described linen
bags saturated with medication to be used to avoid venereal
disease.
In the 17th century condoms were first, used in
England for birth control. It is not certain whether the name
derives from the English physician Condom who recommended lamb
intestines for contraception. The method was quickly exported to
France and became widely used in Paris. They were known There as
“capote anglaise”, while in England they were called “French
letters”.
The latex-based condom was made possible by the
American Charles Goodyear (1800—1860) after he invented the process
of vulcanization. The first large-scale manufacturer (150,000
condoms daily) was in 1920.
CONS
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in 7-13 % of cases the condom may tear during
intercourse
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12 out of 100 couples will conceive during the
first year of condom use
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This is considerably better than the 85% of
conceptions arising from unprotected intercourse, but ranges far
behind the 3 % achieved by female oral contraceptive methods.
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The older the condom, the higher the risk of
damage
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Apparently sexual practice also plays a role -as
some couples always report a higher rate of tearing than others
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couples in stable relationships consider condoms
only as a temporary contraceptive method.
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The acceptability of condoms varies greatly with
cultural factors. It is estimated that in Japan almost four fifths
of couples practicing contraception use condoms. In Africa, however,
their use is less than 1%
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Since the beginning of the AIDS epidemic and the
call for “safe sex” the condom has gained greatly in popularity as a
means of preventing the risk of infection.
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Their effectiveness in preventing HIV infections,
however, is notably less than that of preventing pregnancies (fail
in 31%).
4-Vasectomy and
ITS REVERSAL
Vasectomy is the process of disconnecting "vas
deferens" the internal canal that transports sperm from the
testis to the exterior. Man still ejaculates semen but it is devoid
of sperm. It is a minor surgical procedures and has no effect on
sexual function. It is surgically reversible.
History of Vasectomy:
At the end of the 19th century, vasectomy was
performed to preserve youth and vigour, rather than to prevent
conception.
In the 20’s and 30’s a series of nations passed
laws justifying sterilization for eugenic reasons. So did the Third
Reich.
Vasectomy as a means of contraception became
popular in the 60’s, first in The USA, then in Europe and Third
World nations.
Acceptance Today:
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Countries with particularly rapid population growth like India and
Thailand established vasectomy camps
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In
The USA sterilization was the form of fertility control most
frequently chosen by married couples over 30 years of age.
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In
Germany a frequency of about 50.000 vasectomies per year can be
extrapolated
Surgical Techniques of Vasectomy:
Under anaesthesia (local or general), skin
of the scrotum is cut for 5mm on either side. The vas deferens is
pulled out, cut, and the cut ends are ligated, cauterized and
replaced into the scrotum away from each other.
The procedures requires approximately 10-15
minutes. One leaves the hospital one hour afterwards and can resume
daily activities the next day, but should resume sex after 3 weeks
minimum, and only after the semen analysis shows that semen is
devoid of sperm.
When correctly performed, vasectomy is among the
safest contraceptive methods. Failure rate lies below 1%
Vasectomy Reversal
Undoing vasectomy is possible though surgery
"vasectomy reversal" or through
IVF/ICSI (tube babies).
Basically, vasectomy reversal is re-attaching the
cut end of the vas deferens on one or both sides. The diameter of
the vas deferens is 1-2 mm. Its inner cavity is 1/10mm in diameter.
This very narrow lumen makes re-attaching the vas a challenging -but
possible- process.
There are two ways to re-attach the vas,
conventional and microsurgical.
Conventional Vasectomy Reversal:
The cut ends are attached with
sutures passing through the full thickness of its wall.
Approximately six sutures are placed, all around the circumference.
No microscopic magnification is used. Success rate close to 87%.
Microsurgical Vasectomy Reversal:
The cut ends are re-attached by VERY fine sutures
under microscopic examination. This enables placing two rows of
sutures: one around the inner wall, and another around the outer
wall. Success rate is much higher, close to 99%, but profound
experience and expansive equipment are required, which makes its cost
much higher than that of the conventional way.
