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Tubal Ligation

As with any operation, tubal ligation carries some risk. Minor complications include infection and wound separation and affect between 6 and 11 percent of women, depending on the form of tubal ligation performed. Major complications include heavy blood loss, general anesthesia problems, organ injury during surgery, and need for a larger laparotomy incision during surgery. Approximately 1 to 1.5 percent of women experience major complications.

A tubal ligation will not change your monthly menstrual cycle, nor will it affect your libido. You will still release an egg each month (ovulate) and have menstrual periods; and you will experience menopause at the same time you would have if you had not had the surgery. Your sex drive may in fact increase and you may feel more relaxed about having sex because any concerns about getting pregnant have been removed.

The cost for a tubal ligation runs about $1,200 to $6,000, depending on where you live. If your doctor performs the procedure right after delivery, the costs may be slightly lower; however, if you require hospitalization, the cost will be greater. Some private health insurance companies will cover a portion of the expense.

About 1.5 percent of women who have undergone tubal ligation decide to reverse the procedure, called microscopic tubal ligation reversal. However, a reversal is difficult to perform, considered major surgery, and requires a stay in the hospital. Depending on the method of sterilization used, success can range from 50 to 65 percent; however, if the sterilization damaged much of the fallopian tubes, a reversal may not be possible at all. Up to 60 percent of women who reverse a tubal ligation subsequently conceive a viable baby, but their chances for an ectopic pregnancy increase. In addition, a reversal is an expensive procedure not covered by many insurance companies.

In-vitro fertilization (IVF) offers an alternative to surgical reversal of a tubal ligation. However, most doctors feel that if a tubal ligation can be reversed, it is preferable over an IVF procedure. A reversal requires one procedure to restore fertility, enabling the woman to have as many children as she wants, but a woman may have to undergo several IVF procedures to conceive one child.

With IVF, the woman's eggs are removed directly from her ovaries, fertilized in a laboratory, and the viable embryos are then placed into her uterus. The tubes are simply bypassed in the process. IVF procedures are costly and not covered by most insurance companies; therefore, couples who choose this option will find that there are substantial costs incurred to obtain a pregnancy each time, as well as the possibility of unintended multiple fetuses.

The decision to make contraception permanent is never an easy one. Before you choose any sterilization procedure, ask yourself the following questions:

  • How would you feel if you lost your partner to death or through a divorce and later decided you would like to have a child with another person?

  • One child could never replace another, but if you lost a child would you want to have another baby?

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