Tubal ligation, commonly termed as having “your tubes tied”, is a surgical procedure used as a permanent birth control method in women. In Tubal ligation, (another name is tubal sterilization), the fallopian tubes are either blocked or cut to prevent pregnancy. Fallopian tubes are the two tubes connecting uterus (the womb) with the ovaries on either side. For a pregnancy to occur the male sperm goes up through the uterus into the fallopian tube where it fertilizes the egg that has travelled from the ovary. The Blocking or cutting the fallopian tubes prevents the egg produced in the ovary from travelling to fallopian tubes, thus avoiding its fertilization by the sperm. This process doesn’t affect the working of ovaries and women continue to have normal menstrual cycles.
Why it’s done?
Tubal ligation provides permanent birth control and is usually advisable for;
- adult women who have completed their family
- Women or couples who are certain that they don’t want any pregnancy in future
- If pregnancy carries any health risk for women e.g. a heart condition that is likely to deteriorate with pregnancy
- If women or her partner has a genetic disorder and do not want to pass it over to their off-spring
- The procedure also has a benefit of lowering ovarian cancer risk. Thus, women in their 40’s with a family history of ovarian cancer also can opt for partial or full removal of fallopian tubes to lower their risk of developing ovarian cancer in future.
Types of tubal ligation
Technically several methods for tuba ligation are available including; either closing the fallopian tubes with the help of clips and bands ; or a piece of tube can be cut or stitched or burned with electric current to close the opening of the tube. Another type are tubal implants which are metal spring like devices placed inside the fallopian tube, in this process no cutting or stitching of fallopian tube is involved. The choice of the type of procedure is made by the surgeon considering the condition of the woman.
Tubes tied procedure can be carried out:
- As a laparoscopic procedure; which is a lesser invasive procedure and can be done by inserting surgical instruments and a viewing camera through two small holes in the abdomen
- Open tubal ligation is done with a larger cut in the abdomen and it is usually preferred in women who are already having abdominal surgery e.g. delivering baby through caesarian section or in women who had an abdominal or pelvic region surgery before or those suffering from chronic inflammatory conditions of reproductive system such as pelvic inflammatory disease or endometriosis. In these conditions the organs and tissues in abdomen and pelvis may stick together (adhesions), which make laparoscopic procedure difficult and they need to be dealt through a larger opening in abdomen.
- Tubal ligation can also be performed within 2-3 days after delivery of the baby. The procedure is called mini-laparotomy because the fallopian tubes lie much higher in belly at this time and the procedure can be carried out through a small incision just below the belly button
Tubal ligation side effects
As with any surgery, tubal ligation surgery also has some risks and complications.
Fortunately, major complications occur rarely and they include;
- perforating or injuring a major organ such as uterus, intestines or urinary bladder during procedure; this risk is higher in laparoscopic procedures, Blood loss during the procedure and a larger incision in the abdomen may be required in some cases making surgery more extensive
- Adverse reaction to the drugs used for anesthesia
- Pain and delay in wound healing
- A failed procedure resulting in Incomplete closure of the tubes, which may still make pregnancy a possibility. Statistics tell that about 1 in 200 women undergoing tubal ligation may still become pregnant later on.
- If pregnancy occurs after tubal ligation, there is increased risk of Ectopic pregnancy (pregnancy occurring inside the fallopian tube rather than in the uterus).
This risk of these complications is increased in women;
- Who have PID (pelvic inflammatory disease), endometriosis or previously had a pelvic or abdominal surgery
- Who are over-weight or have diabetes
Can tubal ligation be reversed? Chances of pregnancy after tubal ligation.
Tubal ligation procedure can be reversed but it requires a major surgery known as “reversal procedure”. About 50 -80% of women are able to become pregnant after getting their tubal ligation reversed. For women in whom this reversal procedure is not successful, there are other options such as IVF (in vitro fertilization) available for becoming pregnant.