Tubal Ligation

Tubal ligation, commonly called “tying the tubes”, is the surgical procedure for female sterilization.  Permanent sterility is achieved by preventing transport of the egg (ovum) to the uterus.  The surgery also prevents the sperm from traveling up the fallopian tubes where fertilization normally occurs.

The Procedure

Sterilization is performed using a laparoscope, into which small instruments are inserted through two small incisions in the abdomen. The fallopian tubes are either burned (using electrocauterization or electrocoagulation) or sealed shut (with bands or clips) while the patient sleeps under general anesthesia.  The patient can return home only a few hours after sterilization.

Effectiveness

Except in very rare cases, tubal ligation is 100% effective in preventing pregnancy.

Reversibility

The tubal ligation procedure is reversible, and has been 75-80% successful in women who were deemed candidates for reversal surgery.  However, many women are not considered candidates due to various health issues, and thus sterilization is considered a permanent form of contraception.

Hysteroscopic Sterilization:  Another Option

In hysteroscopic sterilization, a small telescopic device called a hysteroscope is inserted through the vagina and into the uterus, in order to place a small device at the openings to the fallopian tubes, thus blocking them.  This form of sterilization does not involve any anesthesia or incisions, and patients can return to their normal activities the following day.  After three months, x-ray images called hysterosalpingograms are used to check the position of the devices to ensure they are blocking the fallopian tubes.  For those three months, patients are advised to use alternate forms of contraceptives to prevent pregnancy, until success of the procedure has been established.