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Tubal ligation

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."

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Tubal ligation

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Tubal ligation - uterine anatomy

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Description

Tubal ligation is done in a hospital or outpatient clinic.

The procedure takes about 30 minutes.

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.

Another method uses coils that are placed in the tubes at the point where they connect with the uterus (hysteroscopic tubal occlusion procedure). The procedure is done through the cervix. It does not involve cuts in the abdomen and sometimes can be done in a clinic setting without general anesthesia.

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 of 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).

A hysteroscopic tubal occlusion procedure is very hard to reverse. In this case, the best option would be IVF.

Risks

Risks for tubal ligation are:

Before the Procedure

Always tell your health care provider:

During the days before your surgery:

On the day of your surgery:

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 of developing ovarian cancer.

Related Information

Birth control and family planning
Sterilization surgery - making a decision
Condoms - male
Female condoms
Vaginal sponge and spermicides
Emergency contraception
Tubal ligation - discharge

References

Bonnema RA, Spencer AL. Contraception. In: Kellerman RD, Bope ET, eds. Conn's Current Therapy 2018. Philadelphia, PA: Elsevier; 2018;1090-1093.

Isley MM, Katz VL. Postpartum care and long-term health considerations. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 23.

Rivlin K, Westhoff C. Family planning. In:  Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 13.

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Review Date: 1/14/2018  

Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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