Birth Control Permanent Sterilization

For women, permanent sterilization is usually done by a procedure called a tubal ligation. This is commonly known as "having your tubes tied."

For men, a vasectomy is the usual method of birth control permanent sterilization.

Tubal Ligation

A tubal ligation involves cutting the fallopian tubes, which carry eggs from the ovaries to the uterus. In a normal pregnancy, the egg is fertilized by a man's sperm and then implants in the woman's uterus, where it develops into a baby. Tubal ligation prevents pregnancy in two ways: it prevents sperm from reaching an egg and it prevents eggs from reaching the uterus.

Tubal ligation is a surgical procedure. It is often done laparoscopically. The surgeon makes small incisions in the abdomen and inserts a tiny video camera with very small surgical tools. The doctor uses the camera to locate the fallopian tubes, then cuts the tubes and either seals them with clips or uses a technique called cauterization to close the ends by burning them.

Some women choose to have tubal ligation done just after giving birth. At that time, the uterus is still enlarged and the fallopian tubes are easy to reach through a small incision just under the navel. The procedure can be done in less than an hour with a local anesthetic and a sedative. If a woman has had a caesarian section, tubal ligation can often be done before the caesarian incision is closed.

There is a newer method of blocking off the fallopian tubes which does not require any incisions. The doctor inserts a tubelike instrument through the vagina and into the cervix. Then, he/she uses it to push small metallic coils through the uterus and up into the fallopian tubes. The coils stay in the fallopian tubes and cause scar tissue to form, which seals off the tubes.

Vasectomy

When a man chooses to take responsibility for unintentional pregnancies, birth control permanent sterilization can be done as a simple procedure in the doctor's office. A vasectomy involves cutting small tubes in the part of the scrotum called the vas deferens. The vase deferens tubes transport sperm. If the sperm can not get through the tubes, they can not get into the man's semen to make a woman pregnant. Click here for a LoveToKnow article about vasectomy.

Tubal Ligation vs. Vasectomy

When a couple decides on permanent sterilization, they must then decide which partner should undergo a procedure. Vasectomy is a simple procedure with fewer risks than tubal ligation. Neither procedure should cause any change in the person's sex drive or ability to have sex, because they do not affect hormone production. Permanent sterilization procedures also do not affect a person's masculine or feminine characteristics.

Undergoing permanent sterilization is a very personal decision. Each person or each couple should talk with a medical professional and get all questions answered before making a choice.

Effectiveness of Permanent Sterilization

Although no method is perfect for birth control, permanent sterilization is very effective. Only about one in 100 women will become pregnant after having tubal ligation. Only one to three in 1,000 couples will become pregnant after a vasectomy.

Reversing Permanent Sterilization

Many people enjoy no longer having to worry about birth control, but permanent sterilization sometimes can lead to regrets. A man may start a new relationship and want to have a child with his new partner. After losing a child to an illness or an accident, a woman may want to have another. A person may also simply change his/her mind.

Reversing either a tubal ligation or a vasectomy is a much more complicated procedure than having either one done in the first place. Reversal of tubal ligation is a major surgery. It works only 50-80% of the time. The success of vasectomy reversal declines with the length of time since the vasectomy was done. Success rates range from 30-75%.

Read the LoveToKnow article about Vasectomy Reversal for more information about undoing a vasectomy.

For More Information

There is a lot of information on the Internet about birth control permanent sterilization. Here are two sites with articles by medical experts.

• Tubal ligation and Vasectomy at eMedicine.com
• Tubal ligation and Vasectomy at UpToDate.com. UpToDate reviews and updates articles approximately every four months.

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