[2][3] Less commonly, tubal ligation procedures may also be performed for patients who are known to be carriers of mutations in genes that increase the risk of ovarian and fallopian tube cancer, such as BRCA1 and BRCA2.
[8] Occluding or removing both fallopian tubes decreases the likelihood that a sexually transmitted infection can ascend from the vagina to the abdominal cavity, causing pelvic inflammatory disease (PID) or a tubo-ovarian abscess.
[5] Tubal ligation does not eliminate the risk of PID, and does not offer protection against sexually transmitted infections.
[5] Studies of hormone levels and ovarian reserve have demonstrated no significant changes after female sterilization, or inconsistent effects.
[16] Patients who had tubal occlusion surgeries have been found to be four to five times more likely to undergo hysterectomy later in life than those whose partners underwent vasectomy.
[18] Depending on the approach chosen, the patient will need to undergo local, general, or spinal (regional) anesthesia.
If the patient delivers vaginally and desires a postpartum tubal ligation, the surgeon will remove part or all of the fallopian tubes usually one or two days after the birth, during the same hospitalization.
[18] If the patient chooses an interval tubal ligation, the procedure will typically be performed under general anesthesia in a hospital setting.
There are a number of methods of removing or occluding the fallopian tubes, some of which rely on medical implants and devices.
This method has recently become more popular for female sterilization, given evidence to support the fallopian tube as the potential site of origin of some ovarian cancers.
[22] Some large medical systems such as Kaiser Permanente Northern California [23] have endorsed complete bilateral salpingectomy as the preferred means of female sterilization and professional medical societies such as the Society of Gynecologic Oncology [24] and the American College of Obstetricians and Gynecologists (ACOG) recommend discussing the benefits of salpingectomy during counseling for sterilization.
After insertion, scar tissue forms around the coils, blocking off the fallopian tubes and preventing sperm from reaching the egg.
After the procedure, scar tissue formed around the silicone inserts, blocking off the fallopian tubes and preventing sperm from reaching the egg.
All tubal ligation procedures are considered permanent and are not reliably reversible forms of birth control.
Patients who wish to have the option of future pregnancy should ideally be directed towards effective but reversible forms of birth control, rather than sterilization procedures.
[36] Alternatively, in vitro fertilization (IVF) may allow patients with absent or occluded fallopian tubes to successfully carry a pregnancy.
[39] The first modern female sterilization procedure was performed in 1880 by Dr. Samuel Lungren of Toledo, Ohio, in the United States.
[40] Since its development, female sterilization has been periodically performed on patients without their informed consent, often specifically targeting marginalized populations.
This waiting period is not required for private insurance beneficiaries, which has the effect of selectively restricting low-income women's access to tubal sterilization.
[45] Slightly more than 8.2 million women in the US use tubal ligation as their main form of contraception,[45] and approximately 643,000 female sterilization procedures are performed each year in the United States.
[5] A September 2024 study found that states which enacted abortion bans following the ruling in Dobbs v. Jackson Women's Health Organization saw a 39% increase in tubal ligation rates by December 2022.