Issue date: March 2023
Review date: March 2025
Ref: B-246/S/DC/Female sterilisation v4
What is female sterilisation?
Sterilisation works by stopping the egg and the sperm meeting. In female sterilisation (tubal occlusion) this is done by cutting, sealing or blocking the fallopian tubes which carry an egg from the ovary to the uterus (womb).
Sterilisation is a permanent method of contraception, suitable for people who are sure they never want children or do not want more children. You may want to find out about Long Acting Reversible Contraception (LARC) which is as effective as sterilisation, but reversible. A male sterilisation is another alternative to consider and is more effective than female sterilisation. Ask your doctor or nurse for further information about LARC or visit www.fpa.org.uk
How effective is female sterilisation?
The overall failure rate is about 1 in 200 using clips to block the tubes but is more effective when the tube is removed (salpingectomy).
Can anyone be sterilised?
Sterilisation is for people who are sure they do not want more children or any children. You should not decide to be sterilised if you or your partner are not completely sure or if you are under any stress, for example after a birth, miscarriage, abortion or family or relationship crisis.
Research shows that more women and men regret sterilisation if they were sterilised when they were under the age of 30, had no children or were not in a relationship.
You must decide that you do not want more children even with a new partner in the future.
What information should I receive before I decide to be sterilised?
You should get full information and counselling if you want to be sterilised. This gives you a chance to talk about the operation in detail and any concerns you may have.
You should be aware of:
- Other highly effective Long-Acting Reversible Contraception (LARC) and male sterilisation.
- The change in your periods if you are currently using a hormonal method of contraception which can often make them lighter and less painful. Many women ask to go back onto hormonal contraception despite being sterilised.
- Sterilisation failure rates.
- Possible surgical complications.
- Sterilisation is permanent. Reversal following clip sterilisation is not available on the NHS. IVF treatment following a salpingectomy is not available on the NHS.
- The need to use contraception until the next period or at least 7 days (a coil cannot always be removed at the same time)
- The possibility of regretting the procedure.
- The risk of an ectopic pregnancy (a pregnancy outside the womb).
- The small possibility of not being able to complete the procedure.
- You will not be protected against sexually transmitted infections.
- Sterilisation does not affect your hormones. Therefore, your sex drive and enjoyment of sex should not be affected.
How is female sterilisation done?
There are several ways of blocking the fallopian tubes and at Derriford Hospital we can put clips onto the fallopian tubes but we generally recommend removal of the fallopian tube. Many doctors favour removal of the tubes (Salpingectomy) instead of using clips as the tubes have a role in the development of ovarian cancer and so the operation can be seen as being protective against cancer at the same time as providing you with better contraception.
Most sterilisations are done with a keyhole operation called a laparoscopy as a day case operation under a general anaesthetic. A doctor will make a tiny cut in your belly button and insert a laparoscope (a camera), which lets the doctor clearly see your reproductive organs. The doctor will remove or block your fallopian tubes and so you will need a few more small (0.5-1cm) holes on your abdomen for the extra instruments that are used.
A separate information leaflet is available for laparoscopy.
What are the surgical complications?
If you have chosen to have a keyhole operation (laparoscopy) this can be done slightly faster with clips than if your doctor removes the whole tube but the risks and recovery are still very similar for both options. As with all operations there is a risk of bleeding, infection and damage to other organs such as your bladder, bowel or blood vessels. Very occasionally a bigger cut on the abdomen is needed (laparotomy) to fix any complications that may have occurred. These are discussed in more detail in the leaflet on laparoscopy where you can also find other advice regarding your admission and recovery.