Tubal ligation is a method of female contraception. It involves closing the fallopian tubes to prevent fertilization. It is a method considered irreversible. What does this method consist of and how does it work?

Tubal ligation is a method of female sterilization for contraceptive purposes. This is a surgical act that is performed in the hospital. The big difference between this method of female contraception and other existing methods, is that the tubal ligation is permanent. Considered as irreversible, it therefore implies a desire not to or no longer to have children. There are three methods of sterilization causing tubal obstruction in women:

• ligation;
• electrocoagulation;
• the installation of rings or clips.

The goal of a contraceptive method is to prevent ovulation, fertilization between the egg and the sperm or even implantation. In this case, the idea is to ligate, that is to say to close, the fallopian tubes. Thus, the egg cannot descend into the uterus after it comes out of the ovary during ovulation. The encounter with the sperm cannot take place and fertilization is thus avoided. While tubal ligation is a method of birth control and helps prevent pregnancy, it does not protect against sexually transmitted diseases. It is therefore necessary to use a condom in addition if necessary.

Tubal ligation is permitted by law in adults. However, each doctor is free to refuse to perform this intervention. In this case, he is required to announce it during the first consultation and to refer the patient to a colleague who can perform the operation. It is important to remember that, according to the law, the age, the number of children and the marital status do not condition the possibility of performing a tubal ligation.

The purpose of a contraceptive method is to prevent a possible pregnancy. There are a number of reversible techniques to prevent fertilization:

• pill ;
• IUD;
• condom;
• implant ;
• diaphragm;
• etc.

However, in some cases such as no desire for a child or the desired number of children achieved, tubal ligation may be preferred. Indeed, a definitive method of contraception allows you to experience your sexuality without having to worry about your contraception. This also helps to avoid the inconveniences (forgetting a pill, breaking the condom, etc.) or possible complications related to other contraceptive methods.

The intervention and the procedures are defined by law. The steps are as follows:

• The initial consultation. The patient and the doctor will discuss the procedure and the reasons for the request. The patient must be “free, motivated and deliberate”. For this, the doctor is required to give him certain information on other existing methods of contraception, on tubal ligation (how the procedure is carried out, what are the risks and consequences, etc.) as well as a medical file. written information on the next steps to be taken. If she wishes, the patient can involve her partner in this decision-making process, but only her consent is taken into account. It is also possible to set up support from a psychologist and a psychiatrist to support decision-making;
• The reflection period. The law provides for a period of 4 months for reflection between the request and the surgical intervention. The time limit can only be started after a first consultation with a doctor agreeing to perform the procedure;
• The second consultation. This second consultation takes place after the 4 months of reflection. The patient must confirm in writing her desire to proceed with the operation;
• The intervention. As tubal ligation is a surgical procedure, it must be performed by a doctor in a hospital or clinic. Under general anesthesia, the procedure can be performed by laparoscopy (via small incisions through the abdomen), vaginally, or during surgery for another reason. Hospitalization is 1 to 3 days.

It is a very effective method of contraception, in the order of 99%. If you want a child, it is possible to try a restorative operation, but it is a very heavy operation, the result of which is very uncertain. Tubal ligation should be considered as an irreversible sterilization method, in order to make an informed decision.

Tubal ligation does not impact the menstrual cycle which continues to proceed normally. It therefore has no consequences on hormonal balance or libido.

The most common and mild side effects after surgery are abdominal pain. Postoperative complications are rare and not very serious.

In very rare cases, sterilization can fail and result in pregnancy. As the tubes are damaged, the pregnancy can be ectopic. In the event of a late period, it is important to consult a doctor. The following symptoms should prompt an emergency consultation:

• abdominal pain of varying intensity, sudden onset, often lateralized;
• vaginal bleeding, especially if the last period has been delayed or if it has not happened;
• fatigue, dizziness.