Sterilization (tubal ligation)

This article focuses on female sterilization (tubal ligation). 

Sterilization is a permanent form of birth control that is irreversible. Female sterilization involves laparoscopic (key-hole) tubal ligation as a day surgery under general anaesthesia, where the fallopian tubes are clipped or tied off to prevent the egg from meeting the sperm. It can also be performed at the time of C-section. Ligation does not affect sex or your periods. 

Male sterilization involves a vasectomy as a day surgery under either local or general anaesthesia, where the vas deferens are clipped or tied off to prevent sperm from being released into the semen. 

What are the risks of tubal ligation?

Common (affecting 1-5% of patients):

• Bleeding/ bruising at wound site
• Shoulder tip pain
• Infection
• Clip migration

Uncommon (affecting 0.1-1% of patients):

• Failure of sterilisation (1:200 chance of unplanning pregnancy – this may be higher if ligation is done immediately after childbirth or abortion)
• Ectopic pregnancy 
• Failure to gain entry into the abdomen 
• Injury to surrounding organs e.g. intestines, bladder, blood vessels 

Rare (affecting <0.1% of patients):

• Anaesthesia complications
• Uterine perforation: this may require steps to stop bleeding or additional stitches
• Death: the risk is approximately less than 3-8 in 100 000

What are my alternatives besides tubal ligation if I am not planning for more kids?

You may consider long-acting reversible contraception options e.g. IUD or contraceptive implant (implanon), which last between 3-5 years.

What happens if I regret after having a tubal ligation?

Although reversal of tubal ligation is possible, it is technically challenging and success rates are low, with an increased risk of ectopic pregnancies and the tubes becoming blocked again after reversal surgery. It is important to be sure of your decision before going for a tubal ligation – speak to your gynaecologist for further advice.