What is tubal ligation. How is the procedure performed. What are the benefits and risks of tubal ligation. Can tubal ligation be reversed. 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 “having one’s tubes tied,” is a surgical procedure designed to permanently prevent pregnancy in women. This method of contraception involves closing or blocking the fallopian tubes, which connect the ovaries to the uterus. By interrupting this pathway, the procedure prevents sperm from reaching and fertilizing an egg, effectively rendering the woman sterile.

The fallopian tubes play a crucial role in the reproductive process. They serve as the conduit through which an egg travels from the ovary to the uterus. When these tubes are blocked or sealed, the egg can no longer make this journey, thus preventing conception.

How does tubal ligation differ from other contraceptive methods?

Unlike temporary forms of birth control such as pills, patches, or intrauterine devices (IUDs), tubal ligation is considered a permanent solution. It offers a high level of effectiveness without the need for ongoing maintenance or hormone supplementation. This makes it an attractive option for women who are certain they do not want to conceive in the future.

The Tubal Ligation Procedure: What to Expect

Tubal ligation is typically performed in a hospital or outpatient clinic setting. The procedure usually takes about 30 minutes and can be done under general anesthesia or spinal anesthesia with sedation. Here’s a step-by-step breakdown of the process:

1. Anesthesia administration: The patient is given either general anesthesia or spinal anesthesia with sedation.
2. Incision: The surgeon makes one or two small incisions in the abdomen, often near the navel.
3. Abdominal expansion: In some cases, gas may be pumped into the abdomen to create space for better visibility.
4. Laparoscope insertion: A narrow tube with a tiny camera (laparoscope) is inserted through the incision.
5. Tube occlusion: The fallopian tubes are either cauterized (burned shut), clamped with a clip or ring, or surgically removed.
6. Closure: The incisions are closed, completing the procedure.

It’s worth noting that tubal ligation can also be performed immediately after childbirth, either through a small incision in the navel or during a cesarean section.

Are there different methods of performing tubal ligation?

Yes, there are several techniques used to block the fallopian tubes during tubal ligation:

• Cauterization: The tubes are burned shut using an electrical current.
• Clips or rings: Small devices are placed on the tubes to block them.
• Complete removal: The entire fallopian tube is surgically removed, which may further reduce the risk of ovarian cancer.

The choice of method depends on various factors, including the surgeon’s preference and the patient’s individual circumstances.

Benefits and Considerations of Tubal Ligation

Tubal ligation offers several advantages as a contraceptive method, but it’s important to carefully consider the implications before opting for this procedure.

What are the main benefits of tubal ligation?

The primary benefits of tubal ligation include:

• Highly effective contraception: Tubal ligation is over 99% effective in preventing pregnancy.
• Permanence: It provides a long-term solution for women who are certain they don’t want future pregnancies.
• Hormone-free: Unlike some other contraceptive methods, tubal ligation doesn’t involve hormonal changes.
• Reduced ovarian cancer risk: Some studies suggest that tubal ligation may lower the risk of ovarian cancer, especially when the entire fallopian tube is removed.
• Peace of mind: Many women report feeling relieved and less anxious about unintended pregnancies after the procedure.

Who should consider tubal ligation?

Tubal ligation is generally recommended for adult women who are certain they do not want to become pregnant in the future. It may be particularly suitable for:

• Women who have completed their families
• Those with medical conditions that make pregnancy risky
• Women in their 40s or those with a family history of ovarian cancer (who may benefit from complete tube removal)

However, it’s crucial to note that the decision to undergo tubal ligation should not be taken lightly. Women, especially younger ones, should carefully consider their future plans and potential life changes before opting for this permanent form of contraception.

Risks and Potential Complications of Tubal Ligation

While tubal ligation is generally considered a safe procedure, like any surgery, it carries some risks. It’s important for women to be aware of these potential complications before deciding to undergo the procedure.

What are the main risks associated with tubal ligation?

The primary risks of tubal ligation include:

• Incomplete closure: In rare cases, the tubes may not be completely closed, which could lead to pregnancy. The failure rate is about 1 in 200 women.
• Ectopic pregnancy: If pregnancy does occur after tubal ligation, there’s an increased risk of it being ectopic (developing outside the uterus).
• Surgical complications: There’s a small risk of injury to nearby organs or tissues from surgical instruments.
• Anesthesia risks: As with any procedure involving anesthesia, there are potential risks associated with its use.
• Regret: Some women, particularly those who undergo the procedure at a younger age, may later regret their decision.

It’s important to discuss these risks thoroughly with a healthcare provider before deciding to proceed with tubal ligation.

Effectiveness and Long-Term Outcomes of Tubal Ligation

Tubal ligation is one of the most effective forms of contraception available. However, it’s crucial to understand both its efficacy and potential long-term implications.

How effective is tubal ligation in preventing pregnancy?

Tubal ligation is highly effective, with a success rate of over 99%. This means that fewer than 1 in 100 women will become pregnant in the year following the procedure. However, it’s important to note that no method of contraception is 100% foolproof.

The effectiveness of tubal ligation can depend on various factors, including:

• The specific method used to block the tubes
• The skill and experience of the surgeon
• The woman’s age at the time of the procedure

It’s worth noting that younger women who undergo tubal ligation have a slightly higher chance of pregnancy than older women, possibly due to higher fertility and a longer reproductive lifespan ahead of them.

Are there any long-term health effects of tubal ligation?

Research has shown that tubal ligation does not significantly affect a woman’s long-term health. It does not impact hormone levels, menstrual cycles, or the onset of menopause. Some studies have even suggested a potential protective effect against ovarian cancer, especially when the entire fallopian tube is removed.

However, some women report experiencing a condition called “post-tubal ligation syndrome,” which may include symptoms such as irregular periods, heavier menstrual flow, or increased premenstrual symptoms. While these reports exist, scientific evidence supporting this syndrome is limited, and many experts believe these symptoms may be related to the discontinuation of hormonal birth control rather than the tubal ligation itself.

Reversibility and Alternatives to Tubal Ligation

While tubal ligation is considered a permanent form of contraception, it’s important to understand the possibilities for reversal and alternative options available.

Can tubal ligation be reversed?

Tubal ligation can sometimes be reversed through a surgical procedure called tubal reanastomosis. However, this is a complex surgery that is not always successful. The success rate for reversal varies, but generally, more than half of women who have their tubal ligation reversed are able to become pregnant.

Factors affecting the success of reversal include:

• The method used in the original tubal ligation
• The amount of fallopian tube remaining
• The woman’s age and overall fertility
• The skill of the surgeon performing the reversal

It’s important to note that tubal reversal is a major surgery that carries its own risks and is often not covered by insurance. Additionally, even if the tubes are successfully reconnected, there’s no guarantee of pregnancy.

What are the alternatives to tubal reversal for women who change their minds?

For women who have had tubal ligation but later desire to have children, in vitro fertilization (IVF) is often a more viable option than tubal reversal. IVF bypasses the fallopian tubes entirely, allowing an egg to be fertilized outside the body and then implanted in the uterus.

The advantages of IVF over tubal reversal include:

• Higher success rates, especially for older women
• Less invasive procedure
• Ability to screen embryos for genetic disorders
• Option to use donor eggs if needed

However, IVF is also expensive and may require multiple cycles to achieve pregnancy. The choice between tubal reversal and IVF should be made in consultation with a fertility specialist, taking into account individual circumstances and preferences.

Alternatives to Tubal Ligation: Exploring Other Contraceptive Options

While tubal ligation is an effective and permanent form of contraception, it’s not the right choice for everyone. There are numerous alternative contraceptive methods available, each with its own benefits and considerations.

What are some long-acting reversible contraceptive options?

Long-acting reversible contraceptives (LARCs) are highly effective methods that don’t require daily attention. These include:

• Intrauterine Devices (IUDs): Small T-shaped devices inserted into the uterus. They can be hormonal or non-hormonal and last for 3-10 years.
• Contraceptive Implants: Small rods inserted under the skin of the upper arm that release hormones. They last for up to 3 years.

LARCs are nearly as effective as tubal ligation but are reversible, making them a good option for women who may want children in the future.

What about hormonal contraceptive methods?

Hormonal contraceptives work by altering the body’s hormone levels to prevent ovulation. Options include:

• Birth Control Pills: Taken daily, these can be combined (estrogen and progestin) or progestin-only.
• Patches: Applied to the skin weekly.
• Vaginal Rings: Inserted monthly.
• Injectable Contraceptives: Given every three months.

These methods are highly effective when used correctly but require consistent use.

Are there non-hormonal contraceptive options?

For women who prefer to avoid hormonal methods, options include:

• Copper IUD: A non-hormonal device that can last up to 10 years.
• Barrier Methods: Such as condoms, diaphragms, and cervical caps.
• Fertility Awareness Methods: Tracking fertility signs to avoid pregnancy.
• Sterilization for Male Partners: Vasectomy is a simpler and less invasive procedure than tubal ligation.

These methods vary in effectiveness and may require more active participation from the user.

Making the Decision: Factors to Consider Before Choosing Tubal Ligation

Deciding to undergo tubal ligation is a significant choice that requires careful consideration. There are several important factors to weigh before making this permanent decision.

How certain are you about not wanting future pregnancies?

This is perhaps the most crucial question to ask yourself. Tubal ligation should be considered only if you’re absolutely certain you don’t want to have children in the future. Consider your current life circumstances and try to imagine how you might feel about having children in 5, 10, or even 20 years.

What is your current age and life stage?

Younger women are more likely to regret their decision to have tubal ligation later in life. If you’re in your 20s or early 30s, it’s worth considering whether a long-acting reversible contraceptive might be a better option for now.

Have you discussed this decision with your partner?

If you’re in a committed relationship, it’s important to have an open and honest discussion with your partner about this decision. Consider whether a vasectomy for a male partner might be a less invasive option.

Are there any medical reasons to consider or avoid tubal ligation?

Some medical conditions can make pregnancy risky, which might make tubal ligation a good option. Conversely, certain health issues might increase the risks associated with the surgery. Discuss your medical history thoroughly with your healthcare provider.

Have you considered the emotional aspects of permanent sterilization?

For some women, the finality of tubal ligation can bring a sense of relief and freedom. For others, it might lead to feelings of loss or regret. It’s important to consider your emotional response to permanent sterilization.

Are you fully informed about the procedure and its alternatives?

Make sure you understand the details of the procedure, including its risks and potential complications. Also, be sure you’re aware of all your contraceptive options, including long-acting reversible methods.

Remember, the decision to have tubal ligation is highly personal and should be made after careful consideration and discussion with healthcare providers. It’s important to take your time, gather all the necessary information, and make a decision that aligns with your long-term life goals and values.

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.

Was this page helpful?

• Yes

• No

Help us improve – how could this information be more helpful?

How did this information help you?

Please answer below.

Are you human? (Sorry, we have to ask!)

Please don’t check this box if you are a human.

You’re the best! Thanks for your feedback.

Thanks for your feedback.

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.

See All Methods

Back to top

Abstinence

Breastfeeding

Cervical Cap

Condom

Diaphragm

FAM

Female Condom

Implant

IUD

The Patch

The Pill

The Ring

The Shot

Spermicide

Sponge

Sterilization

Vasectomy

Withdrawal

We couldn’t access your location, please search for a location.

Zip, City, or State

Please enter a valid 5-digit zip code or city or state.

Please fill out this field.

Service
All Services
Abortion

Abortion Referrals

Birth Control

COVID-19 Vaccine

HIV Services

Men’s Health Care

Mental Health

Morning-After Pill (Emergency Contraception)

Pregnancy Testing & Services

Primary Care

STD Testing, Treatment & Vaccines

Transgender Hormone Therapy

Women’s Health Care

Filter By
All
Telehealth
In-person

Please enter your age and the first day of your last period for more accurate abortion options. Your information is private and anonymous.