Female sterilization surgery is a permanent method of birth control. At the University of Chicago Medicine, female sterilization is offered to people who are confident that they do not desire conception in the future. A person may make this decision if they have a medical condition that would make a pregnancy dangerous or if they desire an irreversible birth control method.

Are you or your partner a candidate for female sterilization (tubal ligation or tubal removal/bilateral
salpingectomy )?

If you or your partner are seriously considering female sterilization surgery, your doctor will conduct an evaluation and either recommend it or suggest an alternative. The evaluation process is personalized and based on a unique combination of complex factors.

Be prepared to discuss your medical history, as well as your reproductive wellness and family planning goals. As part of your comprehensive counseling, you will also learn about highly effective reversible birth control methods. Your doctor will review all of your (and your partner’s) potential options for pregnancy prevention.

Types of Female Sterilization Surgery: Tubal Ligation or Tubal Removal/Bilateral

At the University of Chicago Medicine, our gynecologic surgeons perform two sterilization surgery techniques:

  • Tubal ligation or “getting your tubes tied”: The fallopian tubes are either cut, tied, clipped or occluded (blocked).
  • Tubal removal (bilateral salpingectomy): Both fallopian tubes are completely removed. 

Both techniques are performed laparoscopically, meaning through small incisions in the belly. With this approach, patients generally experience quicker healing and return to normal activity, compared to open surgical procedures.

Some studies suggest that both methods can also decrease the risk of ovarian cancer in women. The decrease in risk may be greater with the bilateral salpingectomy.

What to You Need to Know About Bilateral Salpingectomy and Tubal Ligation Procedures

Tubal ligation and tubal removal are outpatient procedures, meaning you’re released to go home just a few hours after surgery. If your job involves low physical activity (e.g., a “desk job”), most patients can return to work within a week or less. It may require several days, up to an additional week, to return to full activity if you have a more strenuous job.
After the procedure, patients will have abdominal pain that can be treated with prescription pain medication (at least for the first 24 hours) and an anti-inflammatory drug (e.g., ibuprofen or naproxen) as needed. Some patients may experience nausea as a side effect of the anesthesia used during the procedure. As with any surgery, there are risks that are rare but will be discussed in detail with your doctor.

Is tubal ligation reversal possible?

Although it may be an option, if you or your partner are open to the possibility of tubal reversal, female sterilization is not recommended as a birth control method. Instead, you should talk with your doctor about effective pregnancy prevention options that may work better for you.

It is possible in some cases, but rarely recommended.

The rate of success for tubal reversal depends on a few factors, including:

  • Technique or type of tubal ligation, meaning whether the fallopian tube was cut, tied, clipped or blocked (For example, your surgeon can reconnect the two ends of a tube that has been cut.)
  • Degree of damage to the fallopian tubes
  • Portion of healthy fallopian tube remaining
  • Age at time of reversal
  • General condition of the fallopian tubes, which can depend on the presence of scar tissue or endometriosis
  • Various other fertility factors

Generally, success of reversal is higher if there is still a large portion of healthy tube remaining.

No. Reversal is not possible after a complete tubal removal surgery.

Yes. Essure implants can be removed. The process of removal can be more or less complex, depending on the surgical technique and other considerations.

Techniques for Essure implant removal include:

  • Tubal removal (bilateral salpingectomy): Both fallopian tubes are completely removed.
  • Hysteroscopic removal: In some cases, Essure implants can be removed in a hysteroscopic procedure. This technique is not always successful, especially if the implant is tightly embedded within the tissue of the tube.
  • Bilateral cornua removal: The removal of the tubes in addition to the point of attachment between the tube and the uterus, called the cornua. This is performed when the Essure implant is completely embedded within the cornua. This is a more complex laparoscopic surgery, and the risk of hysterectomy — although rare — must be considered.

These Essure removal techniques are generally considered low-risk surgeries. However, as with any surgery, there are risks that must be considered and should be discussed in detail with your doctor prior to surgery.