Tubal Ligation (Tubectomy) – Methods, Side Effects & Reversal

Tubal ligation is considered to be the most effective method of female birth control. After this procedure, pregnancy is impossible. It is recommended to women who are not planning to have children in the future and in cases when pregnancy may be dangerous and painful.

During the tubal ligation, the fallopian tubes are cut or blocked to permanently prevent pregnancy. Female sterilization and surgical contraception are the most effective methods of contraception. Nowadays special metal springs are used, they do not require surgery.  Sometime later the scar tissue is formed which blocks the tubes.

As it is known after the egg leaves the ovaries and travels through the fallopian tubes towards the uterus where it is fertilized and then reaches the uterine cavity.  As the way is blocked, fertilization does not happen as well as pregnancy.

It is necessary to know that tubal ligation is the voluntary refusal of having children. Of course, the functioning of the tubes may be restored but the chances that the woman will be able to have children are very low. Only professionals are able to perform such a surgery.

Methods of Tubal Ligation

Blocking of the fallopian tubes may be performed in several ways such as tying, burning (electrocautery), cutting, stitching and etc. Each is done with the help of various methods.

Laparoscopy is performed under a general anesthetic. A viewing instrument is inserted through the small incision (2 inches) in the abdomen. Then another incision is done for surgical tools. Very often this method of surgical contraception is carried out after about 24-36 hours after childbirth.

Tubal ligation through the vagina is performed with the help of colpotomy. The doctor makes an incision through the back wall of the vagina in order to reach the abdominal cavity. The scars are rarely left after the surgery but the risk of infection is high.  That is why sexual intercourse is not allowed for at least a month.

Uterine endoscopy is one of the modern ways of blocking the fallopian tubes.

Tubal ligation is a serious surgery and there are some possible side effects. The allergy to anesthesia, bleeding, ectopic pregnancy, and blood poisoning are the most common side effects.

It is possible to restore the tubes but the probability of a positive result is very low. That is why tubal ligation is an irreversible method of contraception.

How are tubal implants inserted?  It takes no longer than half an hour. A specialist opens the cervix of the uterus with the help of instruments and then carefully inserts an implant through the cervix and then the uterus itself into one fallopian tube then into the other. The woman begins to feel spasms similar to those during the menstrual cycle. After the procedure, the doctor checks implants with the help of X-ray. 

During the first three months of using the implants, the woman must use additional contraceptive methods. Then the specialist will insert the dye into the uterine cavity and will perform the hysterosalpingography which will indicate how tight the tubes are blocked by the scar tissue. If everything is alright then there is no need to use other contraceptive methods.


Why Tubal Ligation Is Performed

Tubal ligation may be performed in women over 35 who have at least one child, in those who are not planning to have children, in women with diseases that may get worsened by pregnancy. If there are no diseases, in some countries tubal ligation in nulliparous is impossible.

The Possible Consequences and Risks of Tubal Ligation

Complications caused by tubal ligation are not common. Usually, it may be slight bleeding and allergy to anesthesia. But there is always a risk of damaging inner organs during laparoscopy. Also, the risk increases if the patient has diabetes, smokes or suffers from heart diseases or obesity.

It should be noted that blocking of the fallopian tubes doesn’t affect the ovulatory function or the menstrual cycle or menopause as well. Of course, tubal ligation does not protect from sexually transmitted diseases. That is why contraceptives should be used if you are not certain about your partner.

Before the surgery, the doctor examines the woman carefully and her family relations as well. After some time, the patient may ask to bring the ability to have children back. Lawyers participate as well since the woman must sign the document in order to confirm that she wants this procedure. But before signing, you should remember that according to statistics most women regret that they made such a decision.

Reversal & Fertility

The surgery or the procedure of tubal ligation is aimed to be a permanent birth control method. Means, that fertility may not be restored without additional surgery. However, some methods of tubal ligation are designed the way, that a woman may actually change her mind and restore her fertility.

Sterilization procedures that cause the least amount of damage to the fallopian tubes are the most likely to allow successful tubal ligation reversal. Examples include sterilization with tubal clips or rings.

Procedures that cause scarring to seal off the fallopian tubes, such as the Essure or Adiana systems, generally aren’t reversible. In cases where tubal ligation reversal isn’t recommended, in vitro fertilization (IVF) may be an option. IVF involves retrieving eggs from the ovary, fertilizing them in a lab, and implanting them in the uterus.

Before the tubal ligation reversal the specialist will consider the following factors:

  • The age and weight of the patient
  • The method of tubal ligation performed
  • Possible damage to the fallopian tubes in tubal ligation
  • The length limits of the tube
  • Common fertility factors (eggs remaining and sperm activity)

There are many contraception methods nowadays. Each woman can choose the appropriate way.  The tubal ligation should be done only if there is no other option or the choice for tubal ligation is conscious and well thought out.