Marital status and female and male contraceptive sterilization in the United States

Frequent use of sterilization by unmarried women highlights the importance of educating women on the permanency of sterilization, and an opportunity to increase reliance on long-acting reversible contraceptives.

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Mieke Carine Wim Eeckhaut, Ph.D.

Volume 103, Issue 6, Pages 1509-1515



To examine female and male sterilization patterns in the United States based on marital status, and to determine if sociodemographic characteristics explain these patterns.


Survival analysis of cross-sectional data from the female and male samples from the 2006–2010 National Survey of Family Growth.


Not applicable.


The survey is designed to be representative of the US civilian noninstitutionalized population, ages 15–44 years.



Main Outcome Measure(s):

Vasectomy and tubal sterilization.


In the United States, vasectomy is the near-exclusive domain of married men. Never-married and ever-married single men, and never-married cohabiting men, had a low relative risk (RR) of vasectomy (RR = 0.1, 0.3, and 0.0, respectively), compared with men in first marriages. Tubal sterilization was not limited to currently married, or even to ever-married women, although it was less common among never-married single women (RR = 0.2) and more common among women in higher-order marriages (RR = 1.8), compared with women in first marriages. In contrast to vasectomy, differential use of tubal sterilization by marital status was driven in large part by differences in parity.


This study shows that being unmarried at the time of sterilization—an important risk factor for poststerilization regret—was much more common among women than men. In addition to contributing to the predominance of female, vs. male, sterilization, this pattern highlights the importance of educating women on the permanency of sterilization, and the opportunity to increase reliance on long-acting reversible contraceptive methods.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.