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Tubal Ligation


Updated May 28, 2014

Tubal Ligation

Tubal Ligation

Photo (c) A.D.A.M.

Definition of Tubal Ligation:

Tubal ligation (also commonly referred to as having your tubes tied) is surgery that closes off a woman's fallopian tubes. The fallopian tubes help carry a released egg from the ovaries to the uterus and are usually the place where an egg is fertilized by a sperm. Once the tubes are closed or "tied," sperm will not be able to reach an egg, so pregnancy cannot take place.

Also Known As:

Tying the tubes, tubal sterilization, female sterilization, having your tubes tied, sterilization surgery – female, tube tying, and permanent infertility.

A Permanent Method:

A tubal ligation procedure results in making a woman permanently sterile (unable to get pregnant). This procedure is usually recommended for adult women who are certain that they do not want to get pregnant in the future. Tubal ligation is considered a permanent birth control method. It tends to be a popular choice because women realize that this method can offer extremely effective pregnancy protection for the rest of their reproductive years. Women tend to prefer tubal ligation because of its convenience and lack of side effects that are associated with temporary birth control methods.

Tubal Reversal:

A woman should carefully consider whether or not a tubal ligation is the best method for her. Some women who decide to have this procedure end up regretting their decision later. A woman will be more likely to regret having her tubes tied if she has the procedure done:

  • When she was young
  • If she has few or no children
  • If she chose this method because her partner wanted her to
  • If she decided on a tubal ligation because she believed it would solve money issues and/or that this option will fix relationship problems

A tubal ligation should not be thought of as temporary. Sometimes a tubal reversal can take place if a woman later decides that she wants to become pregnant. However, a tubal reversal is a major surgical procedure; roughly 50% to 80% of women who have their tubal reversed may become pregnant.

The Tubal Ligation Procedure:

A tubal ligation occurs in a hospital or outpatient clinic. It can be performed with:

  • Conscious sedation - woman is awake, relaxed, and drowsy
  • Deep sedation - woman is asleep
  • Anesthesia - local (woman is awake), regional (body is numb from the navel down), or general (woman is asleep)

During the procedure, the fallopian tubes are closed. Some may require a few small incisions made in the abdomen; in these procedures, the tubes are clipped, cut and/or cauterized (sealed shut). Other options, known as Essure or Adiana don't require an incision and uses micro-inserts to stimulate blocking of the tubes.

Which Tubal Ligation Procedure to Use:

The status of a woman’s health may signify which tubal ligation option she is best suited for. Two factors when deciding the safest procedure include a woman’s body weight and whether or not she has had previous surgery.

More than half of all tubal ligations are done right after vaginal childbirth through a small cut near the belly button, during a cesarean section, or abortion. The decision to have a tubal ligation done at this time should be made in advance with your doctor. The Essure, no-incision method, can't be done until at least 6 weeks after a woman has given birth, had a miscarriage, or had an abortion.


Generally, there are three types of risks associated with tubal ligation.

  • Risks due to the actual procedure. These can include incomplete closure of the tubes, which could result in a woman becoming pregnant in the future (this effects approximately 1 out of 200 women), injury to nearby organs or structures caused by surgical instruments, and an increased possibility of an ectopic pregnancy if pregnancy occurs after a tubal ligation.

  • Risks stemming from the use of anesthesia. These can include reactions to the medication and breathing problems.

  • Risks of surgery, in general. These include infection and bleeding.

After a Tubal Ligation Procedure:

Most women can return to work within a few days after having a tubal ligation. Pain medication can help to relieve any discomfort. It is recommended that women avoid strenuous exercise for several days. In general, most women feel ready to have sex again within a week.

The majority of women recover from this procedure with no problems. Unlike with male sterilization (vasectomy), no tests are required to check for sterility.

A tubal ligation does not decrease a woman's sexual pleasure and doesn't affect her femininity. Since no glands or organs are removed or changed and all hormones will still be produced, a tubal ligation should not change sexuality or interfere with the functioning of a woman's sexual organs.


The one-time cost of a tubal ligation, as compared to other contraceptive methods, could save you hundreds of dollars over time.

A woman should check with her health insurance policy as coverage for birth control varies. Medicaid may cover these costs. The cost of a having a tubal ligation may range between $1,000 to $3,000.


Tubal ligation is more than 99 percent effective in the first year. This means that that out of every 100 women who have this procedure done, less than one will become pregnant during the first year of use.

Up to one out of every 100 women will become pregnant in each subsequent year following the first year (when the procedure was done). This is due to a slight possibility that fallopian tubes may reconnect by themselves.

Of every 1,000 women who have undergone tubal ligation, approximately 18.5 will become pregnant within 10 years. These statistics were concluded by the U.S. Collaborative Review of Sterilization in their hallmark Crest study. However, depending on the method used and the age of the woman when she has the procedure done, this rate might be higher or lower.

If a pregnancy does occur after a tubal ligation, there is a 33% chance of it being an ectopic pregnancy. However, the overall rate of pregnancy is so low, that a woman’s chance of having an ectopic pregnancy is much lower than it would be provided she did not have the tubal ligation done in the first place.

STD Protection:

A tubal ligation provides no protection against sexually transmitted infections.


Peterson, H. B., Xia, Z., Hughes, J. M., Wilcox, L. S., Tylor, L. R., & Trussell, J. (1996). The risk of pregnancy after tubal sterilization: Findings from the U.S. Collaborative Review of Sterilization. American Journal of Obstetrics and Gynecology, 174, pp. 1161–1170. Accessed via pivate subscription.

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