Tubal Ligation for Female Sterilization
Failure Rate: 0.4%
Surgical sterilization is a very
effective way to achieve permanent infertility and has a failure
rate of only 0.4% per year. In women, the process is often referred to
as "tying the tubes," but in actuality the fallopian
tubes may be tied, cut, clamped, or blocked. This serves to prevent
sperm from joining the unfertilized egg.
Side Effects and Health Risks
Although sterilization may seem an
attractive alternative to reversible methods, as it dispenses
with the need for forethought and planning before sex, it has
its own set of drawbacks. It is comparatively expensive, costing between $1,000
and $3,000, though often the cost is covered by insurance. Sterilization requires exacting abdominal surgery and anesthesia, both of which carry health risks. Surgical complications
include infection and uterine perforation.
The medical risks
multiply if a hysterectomy (surgical removal of the uterus) is performed for sterilization (as
opposed to simply treating the fallopian tubes); hysterectomy
should never be used for this purpose.
Long term health risks
of sterilization include ectopic pregnancy,
cervical cancer, menstrual
cycle disturbances (increased bleeding and pain), and gynecological
problems necessitating hysterectomy. In fact, for reasons that are not yet clear, women who undergo tubal sterilization are
4 to 5 times more likely to require a hysterectomy than those whose
partners underwent vasectomy.
Sterilization is Permanent
Sterilization should be considered
permanent. Women are sometimes pressured into getting sterilized
by well-meaning medical professionals or social workers. Women
are especially susceptible to this sort of pressure right after
a trying pregnancy or abortion. Many are under the mistaken impression
that sterilization is easily undone.
One in three sterilized
women regret their decision at some point in their lives, and
many seek to have the procedure reversed. Reversals are very
expensive — costing $10,000 or more, and results are iffy. Common
reasons women seek reversal are because of a change in marital
status, the death of a child, or just because they want more children.
For this reason, sterilization is not recommended unless you
have a medical condition that would make pregnancy difficult or
dangerous. Male sterilization, or vasectomy,
is medically safer but should also be considered permanent.
Female Sterilization Reversal
In-vitro fertilization (IVF) or microsurgical tubal reversal
can be considered for women who want more children. Success is not guaranteed with either approach, and the options must be weighed carefully in consultation with a medical specialist.
Surgery, especially major abdominal surgery, carries health risks, including risks due to anesthesia. Ectopic (tubal) pregnancy is very dangerous and is more common
among pregnancies occurring after surgical reversal of female sterilization
(ectopic pregnancy rates range from 1% to 7% or higher).
Both IVF and reversal surgery are expensive and are often not covered
by health insurance.
- At this site:
- The following links are provided as an informational resource or counterpoint and are not necessarily endorsed by the author:
Image Credits: R. A. Hatcher et al., "Contraceptive Technology,"
16th Revised Ed., Irvington Publishers, 1994. p. 386.
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