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The emergence of hysteroscopic approaches has broadened choices for women who seek sterilization. An advantage of hysteroscopic sterilization is that such procedures can be performed in the operating room (OR) or in the office. A disadvantage of the hysteroscopic approach, however, is a lower initial success rate than that of laparoscopic procedures. Some women in whom hysteroscopic sterilization fails ultimately proceed with laparoscopy. Furthermore, in contrast to women who choose laparoscopic sterilization, those who opt for hysteroscopic procedures should use backup contraception for 3 months, then undergo hysterosalpingograms to confirm that sterilization was successful. Almost one third of women who undergo hysteroscopic sterilization…