Female sterilisation involves blocking or cutting the Fallopian tubes (where eggs travel from the ovaries to the uterus) to prevent the ova (eggs) from coming in contact with sperm. After sterilisation, an ovum (egg) is still released each month but is absorbed by the body.

  • Blocking of Fallopian (uterine) tubes to prevent pregnancy
  • Meant to be permanent – difficult to reverse
  • Safe, effective, works immediately
  • A surgical procedure
  • A low failure rate
  • The methods used for female sterilisation are laparoscopic sterilisation, mini-laparotomy and hysteroscopic sterilisation (EssureTM). The method used will depend on a woman’s wishes, general health and past surgical history.

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Laparoscopic sterilisation

This is a common method of female sterilisation and is usually done under general anaesthetic. Two or three very small cuts are made in the abdomen. The abdomen is filled with a carbon dioxide gas, which allows the organs inside to be seen clearly. A laparoscope (medical telescope) is inserted through one small opening to locate the Fallopian tubes. The tubes are then blocked by heat sealing, clips, clamps or rings.

Mini-laparotomy

The mini-laparotomy, also performed with a general anaesthetic, involves a small cut in the lower abdomen, giving access to the Fallopian tubes. Heat sealing, clips, clamps or rings are used to block the tubes.

Hysteroscopic sterilisation

The Essure TM method of permanent birth control uses very small coils, which are inserted through the cervix and uterus into the fallopian tubes. After the coils are placed, scar tissue develops around them, causing the tubes to become sealed shut. This process happens gradually over time, and the woman must therefore use another form of birth control for three months after the coils are placed. At this time, an x-ray test called a hysterosalpingogram (HSG) is performed to confirm that the tubes are blocked. Hysteroscopic sterilisation costs less, allows the woman to spend less time in the hospital, is well tolerated, and causes less severe post-operative pain.

The disadvantages of hysteroscopic sterilisation include:

  • the possibility that the coils cannot be successfully placed in both tubes (<2 percent)
  • the need for another method of birth control for three months after the coils are placed
  • the need for a test to confirm that the procedure has been successful
  • the some women may report persistent pelvic pain
  • the spotting from 2 weeks to 6 months while the IUD settles in.
  • a follow-up visit will be made for 3-4 weeks to check on the placement and the bleeding pattern.

How effective is female sterilisation?

These methods of female sterilisation are 99.5% effective as a form of contraception, starting immediately after the operation. This means that, on average, of 1000 women who have been sterilised, 2-5 of them may become pregnant at some time in the future.

What are the advantages of female sterilisation?

  • A highly effective method of contraception
  • Effective immediately
  • Does not interfere with sexual function
  • Long-term complications are rare

What are the disadvantages of female sterilisation?

Usually requires a general anaesthetic

  • The general risks for a surgical procedure are bleeding and infection; specific for this procedure would be damage to other structures inside the abdomen.
  • Periods may become heavier if the woman has previously been on the COCP
  • If pregnancy does occur there is an increased risk of this being an ectopic pregnancy (pregnancy in the Fallopian tube)