• Permanent contraception for women who will not want more children.
• The 2 surgical approaches most often used:

− Minilaparotomy involves making a small incision in the abdomen. The fallopian tubes are brought to the incision to be cut or blocked.

− Laparoscopy involves inserting a long thin tube with a lens in it into the abdomen through a small incision. This laparoscope enables the doctor to see and block or cut the fallopian tubes in the abdomen.

• Also called tubal sterilization, tubal ligation, voluntary surgical contraception, tubectomy, bi-tubal ligation, tying the tubes, minilap, and “the operation.”
• Works because the fallopian tubes are blocked or cut. Eggs released from the ovaries cannot move down the tubes, and so they do not meet sperm.

One of the most effective methods but carries a small risk of failure:

Less than 1 pregnancy per 100 women over the first year after having the sterilization procedure (5 per 1,000). This means that 995 of every 1,000 women relying on female sterilization will not become pregnant.

A small risk of pregnancy remains beyond the first year of use and until the woman reaches menopause.

– Over 10 years of use: About 2 pregnancies per 100 women (18 to 19 per 1,000 women).

Effectiveness varies slightly depending on how the tubes are blocked, but pregnancy rates are low with all techniques. One of the most effective techniques is cutting and tying the cut ends of the fallopian tubes after childbirth (postpartum tubal ligation).

Fertility does not return because sterilization generally cannot be stopped or reversed. The procedure is intended to be permanent. Reversal surgery is difficult, expensive, and not available in most areas. When performed, reversal surgery often does not lead to pregnancy (see Question 7).

Protection against sexually transmitted infections (STIs): none

Side Effects, Health Benefits, Health Risks, and Complications

Side Effects: none 

Known Health Benefits

Helps protect against: Risks of pregnancy
Pelvic inflammatory disease (PID)

May help protect against: ovarian cancer 

Known Health Risks

Uncommon to extremely rare: complications of surgery and anesthesia (see below) 

Uncommon to extremely rare:

Female sterilization is a safe method of contraception. It requires surgery and anesthesia, however, which carry some risks such as infection or abscess of the wound. Serious complications are uncommon. Death, due to the procedure or anesthesia, is extremely rare.

The risk of complications with local anesthesia is significantly lower than with general anesthesia. Complications can be kept to a minimum if appropriate techniques are used and if the procedure is performed in an appropriate setting.

• Female sterilization:
• Does not make women weak.
• Does not cause lasting pain in back, uterus, or abdomen.
• Does not remove a woman’s uterus or lead to a need to have it removed.
• Does not cause hormonal imbalances.
• Does not cause heavier bleeding or irregular bleeding or otherwise change women’s menstrual cycles.
• Does not cause any changes in weight, appetite, or appearance.
• Does not change women’s sexual behavior or sex drive.
• Substantially reduces the risk of ectopic pregnancy.

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