What is tubal ligation. How is the procedure performed. What are the benefits and risks of tubal ligation. Is tubal ligation reversible. Who should consider tubal ligation. How effective is tubal ligation as a contraceptive method. What are the alternatives to tubal ligation.

Understanding Tubal Ligation: The Basics of Female Sterilization

Tubal ligation, commonly known as “tying the tubes,” is a surgical procedure designed to permanently prevent pregnancy in women. This method of contraception involves closing off the fallopian tubes, which connect the ovaries to the uterus. By blocking these tubes, the procedure prevents eggs from traveling from the ovaries to the uterus, effectively making fertilization impossible.

The fallopian tubes play a crucial role in the reproductive system. They serve as the pathway for eggs released by the ovaries to reach the uterus. During tubal ligation, these tubes are surgically altered to prevent the passage of eggs, thereby eliminating the possibility of pregnancy.

Key Facts About Tubal Ligation

• It is considered a permanent form of birth control
• The procedure is typically performed in a hospital or outpatient clinic
• Recovery time is relatively short, with most women returning to normal activities within a few days
• Tubal ligation does not affect hormonal balance or menstrual cycles

The Tubal Ligation Procedure: What to Expect

Tubal ligation is a surgical procedure that typically takes about 30 minutes to complete. It can be performed under general anesthesia, where the patient is completely asleep, or with spinal anesthesia, where the patient remains awake but feels no pain below the waist.

How is tubal ligation performed? The surgeon makes one or two small incisions in the abdomen, usually near the navel. A laparoscope, which is a narrow tube with a tiny camera, is inserted through one of these incisions. This allows the surgeon to view the fallopian tubes on a monitor. Special instruments are then used to block the tubes using one of several methods:

• Cauterization: The tubes are burned and sealed shut
• Clips or rings: Small devices are placed on the tubes to block them
• Removal: The tubes are completely cut and removed

In some cases, tubal ligation can be performed immediately after childbirth, either through a small incision near the navel or during a cesarean section.

Benefits and Advantages of Choosing Tubal Ligation

Tubal ligation offers several benefits as a contraceptive method, making it an attractive option for many women who have completed their families or are certain they do not want children.

Effectiveness and Peace of Mind

How effective is tubal ligation as a contraceptive method? Tubal ligation is one of the most effective forms of birth control available, with a success rate of over 99%. This high level of effectiveness provides women with peace of mind and freedom from the worry of unintended pregnancy.

Long-term Cost-effectiveness

While the initial cost of tubal ligation may be higher than other contraceptive methods, it is a one-time expense. Over time, this can make it more cost-effective than ongoing purchases of birth control pills, condoms, or other temporary methods.

Hormone-free Contraception

Unlike hormonal birth control methods, tubal ligation does not introduce any hormones into the body. This makes it an excellent option for women who experience side effects from hormonal contraceptives or prefer to avoid them altogether.

Potential Health Benefits

Some studies suggest that tubal ligation may offer additional health benefits beyond contraception. For instance, it has been associated with a reduced risk of ovarian cancer, particularly when the entire fallopian tube is removed during the procedure.

Potential Risks and Considerations of Tubal Ligation

While tubal ligation is generally safe and effective, like any surgical procedure, it does carry some risks that women should be aware of before making a decision.

Surgical Risks

What are the potential complications of tubal ligation? As with any surgery, there are risks associated with anesthesia and the procedure itself. These may include:

• Infection at the incision site
• Bleeding
• Damage to nearby organs or blood vessels
• Adverse reactions to anesthesia

While these complications are rare, it’s important to discuss them with your healthcare provider.

Failure Rate and Ectopic Pregnancy Risk

Although tubal ligation is highly effective, it is not 100% foolproof. About 1 in 200 women may still become pregnant after the procedure. In the rare event of pregnancy following tubal ligation, there is an increased risk of ectopic pregnancy, where the fertilized egg implants outside the uterus, typically in the fallopian tube.

Psychological Considerations

The permanence of tubal ligation can lead to regret in some women, particularly if their life circumstances change. Younger women are more likely to experience regret later in life. It’s crucial to carefully consider this decision and be certain about not wanting future pregnancies.

Reversibility and Alternatives to Tubal Ligation

While tubal ligation is considered a permanent form of contraception, advancements in reproductive medicine have made reversal possible in some cases.

Tubal Ligation Reversal

Is tubal ligation reversible? Yes, but the process is complex and success is not guaranteed. Tubal ligation reversal involves reconnecting the fallopian tubes through microsurgery. The success rate varies depending on factors such as the woman’s age, the type of tubal ligation performed, and the amount of healthy fallopian tube remaining.

More than half of women who undergo tubal reversal are able to become pregnant afterward. However, the procedure is expensive and often not covered by insurance.

In Vitro Fertilization (IVF)

For women who have had tubal ligation but later wish to have children, in vitro fertilization (IVF) is another option. IVF bypasses the blocked fallopian tubes by fertilizing the egg outside the body and then implanting the embryo directly into the uterus.

Alternatives to Tubal Ligation

For women seeking long-term contraception but who are not ready for permanent sterilization, there are several alternatives to consider:

• Intrauterine Devices (IUDs): Long-acting reversible contraceptives that can last for several years
• Hormonal Implants: Small rods inserted under the skin that release contraceptive hormones
• Vasectomy: A sterilization procedure for male partners

Who Should Consider Tubal Ligation?

Tubal ligation is a significant decision that requires careful consideration. It may be an appropriate choice for women who:

• Are certain they do not want to have children in the future
• Have completed their families
• Are at risk for pregnancy-related health problems
• Have genetic disorders they do not wish to pass on
• Prefer a permanent, non-hormonal form of contraception

Who should avoid tubal ligation? Women who are unsure about their future family plans, are under pressure from partners or family members, or are making the decision during times of stress (such as immediately after childbirth) should carefully reconsider or postpone the decision.

The Recovery Process After Tubal Ligation

Recovery from tubal ligation is typically quick, with most women able to return home the same day as the procedure. However, it’s important to understand what to expect during the recovery period.

Immediate Post-operative Period

What can women expect immediately after tubal ligation?

• Some abdominal pain and discomfort, which can be managed with over-the-counter pain medication
• Slight vaginal bleeding or discharge
• Fatigue and dizziness from the anesthesia
• Shoulder pain from the gas used to inflate the abdomen during laparoscopy

Recovery Timeline

Most women can return to normal activities within a few days to a week after the procedure. However, it’s important to follow your doctor’s instructions regarding activity levels and wound care. Typically, women are advised to:

• Avoid heavy lifting for at least a week
• Refrain from sexual intercourse for about a week
• Keep the incision sites clean and dry
• Watch for signs of infection, such as fever or unusual discharge

Full recovery usually occurs within two to three weeks.

Long-term Effects and Lifestyle Changes After Tubal Ligation

Tubal ligation does not typically result in significant long-term effects or require major lifestyle changes. However, there are some important points to consider:

Menstrual Cycle and Hormones

Contrary to some misconceptions, tubal ligation does not affect a woman’s hormonal balance or menstrual cycle. The ovaries continue to produce hormones and release eggs, but these eggs are simply reabsorbed by the body instead of traveling to the uterus.

Sexual Function

Tubal ligation does not affect sexual desire or function. In fact, some women report improved sexual satisfaction due to the elimination of pregnancy concerns.

Ongoing Health Considerations

While tubal ligation provides excellent protection against pregnancy, it does not protect against sexually transmitted infections (STIs). Women who are not in monogamous relationships should continue to use barrier methods like condoms to protect against STIs.

Regular Health Check-ups

Even after tubal ligation, it’s important to continue regular gynecological check-ups and cancer screenings. While the procedure may reduce the risk of certain cancers, it does not eliminate the need for ongoing preventive care.

In conclusion, tubal ligation is a highly effective, permanent form of contraception that offers many benefits for women who are certain they do not want future pregnancies. However, it’s a decision that requires careful consideration of personal circumstances, future plans, and potential risks. Consulting with a healthcare provider can help women make an informed decision about whether tubal ligation is the right choice for their reproductive health needs.

Tubal ligation Information | Mount Sinai

Sterilization surgery – female; Tubal sterilization; Tube tying; Tying the tubes; Hysteroscopic tubal occlusion procedure; Contraception – tubal ligation; Family planning – tubal ligation

Tubal ligation is surgery to close a woman’s fallopian tubes. (It is sometimes called “tying the tubes.”) The fallopian tubes connect the ovaries to the uterus. A woman who has this surgery can no longer get pregnant. This means she is “sterile.”

Surgical sterilization which permanently prevents the transport of the egg to the uterus by means of sealing the fallopian tubes is called tubal ligation, commonly called having one’s tubes tied. This operation can be performed laparoscopically or in conjunction with a Cesarean section, after the baby is delivered. Tubal ligation is considered permanent but reversals can be done in many cases.

The ovaries are connected to the uterus by the uterine tubes (fallopian tubes). The egg travels through the tube to the uterus.

Description

Tubal ligation is done in a hospital or outpatient clinic.

• You may receive general anesthesia. You will be asleep and unable to feel pain.
• Or, you will be awake and given spinal anesthesia. You may also receive medicine to make you sleepy.

The procedure takes about 30 minutes.

• Your surgeon will make 1 or 2 small surgical cuts in your belly. Most often, they are around the belly button. Gas may be pumped into your belly to expand it. This helps your surgeon see your uterus and fallopian tubes.
• A narrow tube with a tiny camera on the end (laparoscope) is inserted into your belly. Instruments to block off your tubes will be inserted through the laparoscope or through a separate small cut.
• The tubes are either burned shut (cauterized), clamped off with a small clip or ring (band), or completely removed surgically.

Tubal ligation can also be done right after you have a baby through a small cut in the navel. It can also be done during a C-section.

Why the Procedure Is Performed

Tubal ligation may be recommended for adult women who are sure they do not want to get pregnant in the future. The benefits of the method include a sure way to protect against pregnancy and the lowered risk for ovarian cancer.

Women who are in their 40s or who have a family history of ovarian cancer may want to have the whole tube removed in order to further decrease their risk of later developing ovarian cancer.

However, some women who choose tubal ligation regret the decision later. The younger the woman is, the more likely she will regret having her tubes tied as she gets older.

Tubal ligation is considered a permanent form of birth control. It is NOT recommended as a short-term method or one that can be reversed. However, major surgery can sometimes restore your ability to have a baby. This is called a reversal. More than half of women who have their tubal ligation reversed are able to become pregnant. An alternative to tubal reversal surgery is to have IVF (in vitro fertilization).

Risks

Risks of tubal ligation are:

• Incomplete closing of the tubes, which could make pregnancy still possible. About 1 out of 200 women who have had tubal ligation get pregnant later.
• Increased risk of a tubal (ectopic) pregnancy if pregnancy occurs after a tubal ligation.
• Injury to nearby organs or tissues from surgical instruments.

Before the Procedure

Always tell your health care provider:

• If you are or could be pregnant
• What drugs you are taking, even drugs, herbs, or supplements you bought without a prescription

During the days before your surgery:

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
• If you smoke, try to stop. Ask your provider for help quitting.

On the day of your surgery:

• You will most often be asked not to drink or eat anything after midnight the night before your surgery, or 8 hours before the time of your surgery.
• Take the drugs your provider told you to take with a small sip of water.
• Your provider will tell you when to arrive at the hospital or clinic.

After the Procedure

You will probably go home the same day you have the procedure. You will need a ride home and will need to have someone with you for the first night if you have general anesthesia.

You will have some tenderness and pain. Your provider will give you a prescription for pain medicine or tell you what over-the-counter pain medicine you can take.

After laparoscopy, many women will have shoulder pain for a few days. This is caused by the gas used in the abdomen to help the surgeon see better during the procedure. You can relieve the gas by lying down.

You can return to most normal activities within a few days, but should avoid heavy lifting for 3 weeks.

If you have the hysteroscopic tubal occlusion procedure, you will need to keep using a birth control method until you have a test called hysterosalpingogram 3 months after the procedure to make sure the tubes are blocked.

Outlook (Prognosis)

Most women will have no problems. Tubal ligation is an effective form of birth control. If the procedure is done with laparoscopy or after delivering a baby, you will NOT need to have any further tests to make sure you cannot get pregnant.

Your periods should return to a normal pattern. If you used hormonal birth control or the Mirena IUD before, then your periods will return to your normal pattern after you stop using these methods.

Women who have a tubal ligation have a decreased risk for developing ovarian cancer.

Isley MM. Postpartum care and long-term health considerations. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe’s Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 24.

Rivlin K, Davis AR. Contraception and abortion. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 13.

Last reviewed on: 1/10/2022

Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Tubal Ligation Procedure | Female Sterilization

In This Section

• Sterilization

• How effective is sterilization?

• How safe is sterilization?

• What can I expect if I get a sterilization procedure?

• How do I get a sterilization?

• What are the benefits of sterilization?

• What are the disadvantages of sterilization?

What is sterilization?

Want to make sure pregnancy is not in your future? Sterilization (sometimes called female sterilization, tubal ligation, or “getting your tubes tied”) is a safe and effective surgical procedure that permanently prevents pregnancy.

What are the types of sterilization?

There are a few different types of tubal sterilization procedures: 

• Tubal ligation is a surgical procedure that permanently closes, cuts, or removes pieces of your fallopian tubes.

• Bilateral salpingectomy is a surgical procedure that removes your fallopian tubes entirely.

• Essure sterilization is a tiny coil that a doctor puts in your fallopian tubes to block them — it used to be a common form of sterilization, but Essure is no longer available in the U.S.

How does sterilization work?

Every month, an egg leaves one of your ovaries (called ovulation). The egg moves through one of your fallopian tubes for a few days, waiting for sperm to fertilize it. Pregnancy happens if a sperm cell meets up with one of your eggs, and the fertilized egg implants in your uterus. When your fallopian tubes are blocked or removed after a sterilization procedure, sperm can’t get to an egg and cause pregnancy.

During a sterilization procedure, you’re put to sleep so you won’t feel or remember anything. The doctor pumps gas into your belly so they can see your organs clearly. They make a small cut under your belly button and put a tiny camera inside your belly to find your fallopian tubes. Then they put a tool in through another small cut in your lower belly to close off your fallopian tubes. They’ll use heat, clips, or rings to seal your tubes shut, or remove your tubes altogether.

You still get your period after sterilization — you just can’t get pregnant because sperm can’t get to your eggs.

Is sterilization right for me?

Sterilization is permanent — you should only get sterilized if you’re totally sure you don’t want to be able to get pregnant for the rest of your life.

Sterilization may not be a good choice for you if:

• There’s any chance you’ll want to get pregnant in the future.

• You’re being pressured by your partner, friends, or family.

• You hope sterilization will solve problems that may be temporary — like marriage or sexual issues, short-term mental or physical illnesses, or money problems.

It’s safe for most people to get sterilized. Your doctor will talk with you about your health and life to help you decide if sterilization is right for you.

Does sterilization protect against STDs?

Nope. Sterilization won’t protect you or your partners from sexually transmitted infections. Use condoms to help lower your chances of getting or spreading STDs.

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Sterilization

• 99% effective

• Costs up to $6,000, but can be $0

• Surgical procedure

• Do it once, lasts forever

Sterilization doesn’t protect you from STDs. Use a condom to help stop STDs.

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