Comparing options for women seeking permanent contraception in high-resource countries: a protocol for a systematic review

Systematic Reviews. 2019;8(1):1-6 DOI 10.1186/s13643-019-0987-7


Journal Homepage

Journal Title: Systematic Reviews

ISSN: 2046-4053 (Online)

Publisher: BMC

LCC Subject Category: Medicine

Country of publisher: United Kingdom

Language of fulltext: English

Full-text formats available: PDF, HTML



Rebecca Gormley (Faculty of Health Sciences, Simon Fraser University)
Brian Vickers (Contraception and Abortion Research Team-Groupe - de recherche sur l’avortement et la contraception (CART-GRAC), BC Women’s Hospital)
Wendy V. Norman (Contraception and Abortion Research Team-Groupe - de recherche sur l’avortement et la contraception (CART-GRAC), BC Women’s Hospital)


Open peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 11 weeks


Abstract | Full Text

Abstract Background For women seeking permanent contraception, there are a variety of options available including surgical techniques such as tubal ligation or bilateral salpingectomy, in-clinic procedures such as hysteroscopic techniques using micro-inserts, or the levonorgestrel-releasing intrauterine contraceptive. Despite the various methods available for women who are seeking permanent contraception, there is not a review or decision-making tool that systematically brings together outcomes related to effectiveness, tolerability, adverse effects, non-contraceptive benefits, recovery, or accessibility: all of which are important for shared decision-making between patients and health care providers. Methods We registered our protocol [on Prospero: CRD42016038254] following PRISMA guidelines. A search strategy was created in collaboration with a librarian, and three databases (EMBASE, PubMed, Web of Science) will be searched along with secondary screening of relevant articles. A third reviewer will adjudicate any discrepancies. Data will be extracted independently according to population, intervention, comparison, outcomes (PICOS); length of follow-up; and funding. Articles will be assessed for bias using the Newcastle-Ottawa Scale and the Cochrane Collaboration tool. If appropriate, a network meta-analysis will be conducted to rank and analyze each method according to each objective. If heterogeneity between studies is too high or it is not possible to conduct a network meta-analysis, a narrative analysis of the study results will be provided. Discussion Clinicians and their patients seeking permanent contraception have several options, yet we were unable to find a systematic review or decision support tool helping to facilitate shared decision-making. This systematic review can inform patients, providers, and health policy decision-makers about which options of permanent contraception will meet different reproductive goals according to various outcomes, which can lead to better health, social, economic, and mental well-being for reproductive age women. This can also aid our understanding of resulting costs to the health care system. Systematic review registration PROSPERO CRD42016038254