Tube Ligation as Permanent Birth Control for Women

For a woman who is sure she doesn't want to have children in the future, tube ligation may be a good option. If you're unsure about wanting more children, you may want to consider other forms of birth control.

Getting your "tubes tied" involves blocking the fallopian tubes so that eggs cannot travel from the ovaries to the uterus, where sperm can fertilize the eggs and cause pregnancy. With your tubes tied, you can have sex without a contraceptive. However, tube ligation doesn't protect you from HIV and other sexually transmitted diseases.

Traditional Tubal Sterilization

Traditional tubal sterilization is a surgery that requires general anesthesia. When getting your tubes tied, your surgeon may close off your fallopian tubes through an incision. There are several types of tubal sterilization:

• The most common method of tube ligation is the "Pomeroy technique:" The surgeon creates a loop in the fallopian tubes, ties them off, and removes the tied off sections.
• During a tubal ring ligation, the surgeon places an elastic ring on the loop in the fallopian tube. The ring cuts off the blood supply to the tissue in the loop, causing scar tissue to form and the sections of the fallopian tube to separate. Tubal ligation with clips is a similar procedure.
• When a woman gets her tubes tied immediately after childbirth, the most common method is the tubal ligation and resection. During this procedure, the surgeon removes cross-sections of both fallopian tubes.
• Another option is tubal coagulation. During this tubal sterilization procedure, the surgeon uses forceps that conduct electricity to grasp the fallopian tube and burn it shut.

You can also consider other, less common procedures. Before you have tubal ligation surgery, discuss your options with your healthcare provider.

Traditional Tubal Sterilization Risks

There are several risks of getting your tubes tied. You may have a bad reaction to the anesthesia, causing:

• Allergic reactions
• Breathing problems
• Pneumonia

Tubal sterilization surgery may also cause:

• Bleeding
• Heart problems
• Infection
• Injury to nearby organs or tissues.

In addition, if the the tubes don't close completely, you could still become pregnant. According to Medline Plus, about 1 in 200 women become pregnant after tube ligation. If you become pregnant, you have an increased risk of a dangerous tubal (ectopic) pregnancy.

Tubal Ligation Reversal

Although these surgeries traditionally required a hospital stay, the Center for Assisted Reproduction reports new outpatient techniques of tube ligation. These reversal procedures involve only a small incision, with a recovery time of only seven to 10 days.

The Center states that tube ligation reversals generally have success rates between 30 and 70 percent. However, success will usually depend on the method originally used to perform the tubal sterilization.

Essure^® Tube Ligation

An alternative to traditional tubal sterilization is Essure®. A doctor inserts this device using a catheter through the vagina and uterus. The Essure^® device blocks the fallopian tubes, preventing pregnancy, and this surgery doesn't require general anesthesia or incision.

After the Essure^® procedure, continue to use other birth control for three months, until a test confirms the fallopian tubes are completely blocked. The Essure^® procedure is permanent and cannot be reversed.

Resources

Center for Assisted Reproduction Staff. (n.d.). Tubal ligation procedures. Retrieved February 9, 2010, from the Center for Assisted Reproduction Web site: http://www.tubalreversalusa.com/html/tubal_ligation.html.

Essure Staff. (n.d.). Overview of Essure. Retrieved February 9, 2010, from the Essure Web site: http://www.essure.com/Home/Understanding/WhatisEssure/tabid/55/Default.aspx.

Medline Plus Staff. (n.d.). Tubal ligation. Retrieved February 9, 2010, from the National Institutes of Health Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002913.htm.