Female Sterilization Procedures: Tubal Ligation and Tubal Occlusion

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  • 0:06 Birth Control
  • 1:24 Tubal Ligation or Closure
  • 4:03 Tubal Occlusion
  • 5:55 Reversal Options
  • 7:31 Lesson Summary
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Lesson Transcript
Instructor: Heather Adewale

Heather has taught reproductive biology and has researched neuro, repro and endocrinology. She has a PhD in Zoology/Biology.

So, you and your spouse have reached that point in life where you are done having kids. What now? In this lesson, you will learn about some of the methods of permanent female sterilization available to women who have decided not to have any more children.

Birth Control

Okay, so you're getting up there in age. You've had a few kids (maybe a set of twins or two) and you and your spouse have decided that you are done having children. So, what now? How do you prevent any future pregnancies? Well, there are a few options, here.

You are probably familiar with the most common option: contraceptives. These are chemical or physical forms of birth control. And, while chemical-based birth control methods (such as birth control pills) or physical methods (such as condoms) are, for the most part, reliable, they are not 100% effective and aren't necessarily a permanent solution.

There are, however, more permanent methods of birth control. These methods are usually surgical in nature. A more permanent method of birth control is often referred to as sterilization. In this lesson, we'll look at the most common types of female sterilization procedures. All of these methods merely impede the passage of gametes from the gonads to the rest of the reproductive system. They do not remove the ovaries or the uterus and, therefore, do not interfere with hormone signaling pathways.

Tubal Ligation or Closure

First, let's take a look at the reproductive anatomy of a female. Below, we see the ovaries, those are where the eggs are produced. Next, we have the uterine (or fallopian) tubes. These transport the egg from the ovary to the uterus.

Tubal sterilization involves blocking, tying or cutting the uterine tubes.
Tubal Sterilization Method

As you may have guessed from the name, tubal sterilization involves the uterine tubes. In tubal sterilization procedures, the doctor blocks, ties or cuts the uterine tubes to impede or prevent passage of the egg from the ovaries to the uterus.

There are a few different types of tubal sterilization, but each one has the same outcome. First, let's look at tubal ligation. In tubal ligation, the doctor cuts, ties or cauterizes the uterine tubes, separating the part of the tube connected to the ovary from the part connected to the uterus.

  1. The doctor makes a small incision in the abdominal wall and inserts a tiny scope, called a laparoscope, through the incision so that he can view the uterine tubes.
  2. A second, small incision is made right above the pubic,or what you might call the bikini, line and a probe is inserted.
  3. Once the uterine tubes are located, the doctor and patient have a few choices. The tubes can be:
  • Cut in half and cauterized, sealing the ends of each half.
  • Cut and tied off.
  • Cut and clamped.
  • Or, the tubes can be kept whole but closed with a band, ring or tubal clip.

Closing the tubes with a band, ring or clip can be thought of like stopping the water flow in a hose. To stop water from flowing out of the hose without cutting the hose in half, you can compress the hose to prevent water flow. A tubal clip is like putting a clamp on a hose, while a tubal band or ring would be like bending or kinking the hose to prevent water flow.

This option is the easiest to reverse and causes the least amount of damage to the uterine tube tissue. However, there is also the possibility that the uterine tube tissue will tear and cause excess bleeding or that the band or clip will fail to prevent passage of the gametes. The failure rate of these types of tubal sterilization, while low, is still higher than those that separate the uterine tube into two pieces.

Tubal Occlusion

Now, you may think that we have covered all the options for blocking passage of gametes (that's the sperm and the egg) through the uterine tubes, but there is one other common method. In this method, called tubal occlusion, the uterine tube is blocked through the insertion of a micro coil or plug. This micro insert is a tiny, spiral, metal coil or a silicon plug that is placed inside each of the uterine tubes. The uterine tissue then grows around the device, kind of like scar tissue, blocking the tube.

In tubal occlusion, a coil or plug is placed in the uterine tube.
Tubal Occlusion Coil

This procedure takes longer to become fully effective at preventing pregnancy because the uterine tube tissue needs time to grow around the microinsert. It's therefore recommended that women use another form of birth control for at least three months following the procedure. Like most of the other tubal sterilization procedures, this is meant to be a permanent solution and is not easily reversed.

Now, you may be thinking, why would one choose this method as opposed to the others if it takes longer to work? Well, this method doesn't require any surgical incisions! Instead, the doctor uses a long, thin scope that is inserted through the vaginal opening and threaded up into the uterine tube. The coil or plug is then placed in the tube, and the procedure is repeated on the other side. See? No surgical incision; you don't even need general anesthesia, and the recovery time is minimal! There is one tiny complication, though. In some cases, patients can experience side effects if the coil is placed improperly or moves before the tissue has grown around it.

Reversal Options

Okay, so now that we know how these sterilization procedures work, what happens if the woman decides later on that she wants to have more children? Maybe she got remarried or simply changed her mind. Is there something she can do now that she has gone through with the tubal sterilization? While all of these methods are intended to be permanent, sometimes they are reversible. Reversal would, however, require a second surgical procedure, and depending on the initial procedure, reversal may not be successful.

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