How is female sterilization performed for contraception?

Updated: Dec 10, 2018
  • Author: Frances E Casey, MD, MPH; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Answer

Answer

Approximately 1 million American women are sterilized either by surgery on the fallopian tubes or by hysterectomy each year. Female sterilization prevents fertilization by interrupting the fallopian tubes.

Sterilization can be performed surgically in the postpartum period with a small transverse infraumbilical incision or during the interval period. Sterilization during the interval period can be performed with laparoscopy, laparotomy, or colpotomy. The methods of fallopian tube sterilization include occlusion with Falope rings, clips, or bands; segmental destruction with electrocoagulation; or suture ligation with partial salpingectomy.

The latest form of female permanent sterilization is the Essure system. This form of sterilization prevents fertilization by interrupting the fallopian tubes; however, the Essure system does not require surgical incisions and can be performed with the patient under local anesthesia. It is performed hysteroscopically, and a microinsert is placed directly into the fallopian tubes. During the first 3 months after the procedure, the fallopian tube and the microinsert create a tissue barrier that prevents sperm from reaching the egg. After the 3-month period, patients must undergo a hysterosalpingogram to ensure placement.


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