Tubal ligation

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Tubal ligation

Tubal ligation is a permanent birth control procedure commonly known as "having your tubes tied." The procedure prevents pregnancy by preventing transport of the egg to the uterus and by blocking the passage of sperm up the fallopian tube to the egg.

Effectiveness rate. In the first year after tubal ligation, the effectiveness rate of this procedure is greater than 99 percent, meaning that less than one woman out of 100 may get pregnant. However, over time it's possible that the tubes could fuse back together. Effectiveness rates of 98 percent have been reported 10 years after the procedure.

Reversal. Although tubal sterilization may be reversible, doing so is difficult. A reversal requires microsurgery to reconnect tiny fallopian tubes. Generally, women who wish to become pregnant after having a tubal ligation will be offered in vitro fertilization, a procedure in which eggs are removed from a woman, fertilized by a man's sperm in the laboratory and implanted in the uterus.

Side effects and health risks. After surgery you may experience temporary side effects, such as fatigue, abdominal pain, dizziness, nausea, gassiness and shoulder pain. Rare complications from the surgery include a reaction to the anesthesia drugs, pelvic infection, bowel or bladder injury, and injury to blood vessels in the abdomen. The rare pregnancy that occurs after a tubal ligation procedure is more likely to be an ectopic pregnancy, in which the fertilized egg starts to develop in a fallopian tube. Ectopic pregnancies require immediate surgical removal, or the fallopian tube could rupture. Tubal ligation doesn't protect against STDs.

What to expect. For tubal ligation, one or two small incisions are made near your navel and above your pubic bone while you're under anesthesia. A laparoscope — a small, lighted magnifying device — is inserted through the incision next to your navel. Using instruments passed through the laparoscope, your doctor cauterizes and seals the fallopian tubes or closes them with plastic rings or clips. Tubal ligation can also be performed immediately after childbirth through a small incision near the navel, during a Caesarean section or through a small incision in the vagina.

Cost. The procedure costs between $2,500 and $4,000.