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Tubal ligation is a permanent method of birth control.

Consider this method only if you are sure that you don't want children in the future.

What is Tubal Ligation

This procedure consists of closing the fallopian tubes, which connect the ovaries and the uterus. Normally, fertilization occurs in the fallopian tubes, where sperm and ovum meet. After fertilization, implantation in the uterus happens.

Tubal ligation can be done by clipping, stitching, banding or cutting the tubes.

It can be done laparoscopically (usually within 24-36 hours after delivery) or laparotomically in cases when other abdominal surgery is needed: for pelvic inflammatory diseases or endometriosis, for example.

Pros and Cons

The advantage of tubal ligation is that it is a permanent birth control method, the costs are low in comparison to other birth control methods because it is a one-time procedure.

The disadvantage of tubal ligation is that it doesn't protect against STIs (sexually transmitted infections) and that women who have a tubal ligation have an increased risk of developing ovarian cancer.

Possible Complications

The complications of tubal ligation can be minor or major. Minor complications are infections and wound separations. Major complications are anesthesia problems, organ injuries during the procedure (mostly bladder and bowel are injured), heavy blood loss, and others.

Tubal Ligation Reversal

Reversal of tubal ligation is possible, but it is rarely done. It requires reconnecting the fallopian tubes and success rates of this procedure are low.

Even though tubal ligation is a permanent method of birth control, can pregnancy still happen?

Pregnancy after tubal ligation can happen when:

  • You were pregnant at the time of the surgery.
  • The surgery was not done correctly (the fallopian tubes are missed, or the closure is not complete).
  • The tubes reconnect - growing back together allowing sperm to fertilize an egg, or a fistula is created allowing a new passage between ovaries and uterus.

If a tubal ligation fails, you have an increased risk of having an ectopic pregnancy. An ectopic pregnancy is the implantation of the embryo outside the uterine cavity. The implantation mostly occurs in the fallopian tube, but it can also occur in the cervix, ovaries and everywhere in the abdomen.

Ectopic pregnancies are more likely to occur three or more years after the procedure.

According to the CREST study, the 10-year cumulative failure rates varied enormously from a low of 0.18% to a high of 5.4%, depending on age at the time of sterilization and method of occlusion used.

If you have any pregnancy symptoms (missed period, nausea, vomiting, breast tenderness, fatigue, etc.) but you have had a tubal ligature in the past do consider the possibility of being pregnant. Take a pregnancy test or visit your gynecologist.

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