(125) INVESTIGATING TRENDS IN MALE AND FEMALE STERILIZATION PROCEDURES AND FOLLOW-UP IN THE POST-DOBBS ERA
Authors: Schammel J , Sura A , Prokopiou N , Patel A , Rosenzweig A , Fuestel P , Inouye B , Mcleod C , Welliver C 
Published: December 2024

Introduction

On June 24, 2022, the ruling of Dobbs vs. Jackson Women’s Health Organization (henceforth, Dobbs) by the Supreme Court of the United States (SCOTUS) led to the overturning of the 1973 Roe v. Wade decision (henceforth, Roe) which now gives individual states the autonomy to establish abortion access. This decision directly affected the reproductive rights of females nationwide; however, the effects may be more or less pronounced based on how individual states decide to either protect or restrict abortion access. Interestingly, these changes have also increased interest in vasectomies along with more consults and procedures. While data has shown an increase in consultations for tubal ligation, studies have been sparse on changes in contraception for females. Females and males have the choice of different contraceptive options based on their personal preferences and individual anatomy. To our knowledge, no single institution has done a comparative study that characterizes the different contraceptive options females and males elected for after the Dobbs decision.

Objective

In light of the recent ruling of Dobbs vs. Jackson Women’s Health Organization by the Supreme Court of the United States, we investigated sterilization and contraception utilization for both males and females at our institution in a state that protects abortion rights (New York).

Methods

We performed a retrospective review of all male and female patients seeking sterilization or contraceptives in the pre-Dobbs era (January 2021-May 2022) compared to the post-Dobbs era (July 2022-December 2022) at our institution. Demographic data for male and female patients was assessed along with contraceptive options utilized.

Results

We noted a change in contraceptive options utilized with more women selecting longer acting (IUD increased from 47 to 48%) and permanent options (salpingectomy increasing from 15 to 24%), pre- and post-Dobbs. Corresponding decreases are seen in shorter acting options like Nexplanon and Depo-Provera. Women undergoing permanent sterilization via salpingectomy had the highest average number of children out of all contraceptive procedures. The number of salpingectomies per month increased from an average of 9.7 pre-Dobbs to 18.3 (± 7.0) post-Dobbs (88.7% increase, p = 0.03). An increase in monthly vasectomies were noted however at a lower rate: 35.6 per month to 53 (49% increase, p = 0.02). Amongst women undergoing salpingectomy, the average number of children decreased post-Dobbs, 2.87 vs. 2.17 (p = &lt;0.0001). The salpingectomy cohort also had the highest percentage of married women and lowest percentage of nulliparous women out of all contraceptive procedures although a trend towards more nulliparous women undergoing salpingectomy was noted (4.88% vs 9.09% pre- and post-Dobbs, p = 0.08). A change in contraceptive options utilized is noted for pre- and post-Dobbs. Completion of semen analysis after vasectomy was not affected by the Dobbs decision (46.6% vs. 46.3%, pre- and post-Dobbs).

Conclusions

Despite living in a state with continued abortion access after the Dobbs decision, women are electing for more invasive and longer acting contraceptive options. The increase in salpingectomy was the largest amongst male or female patients with a decrease in the average number of children for women pursuing salpingectomy.

Disclosure

No.