Family Planning With Sterilization

July 16, 2023
Lisa P Otey, MD


Sterilization is a form of control that is permanent and often irreversible. May it be tubal ligation for women or vasectomy for men, both require surgery. Because sterilization is permanent, you have to be 100% sure about undergoing this procedure. Think about it a lot of times, and be sure that you don’t want to bear any children in the future. Since tubal ligation is a common procedure, your Houston Gynecologist has the expertise to help you make the best decision for your circumstance.

How is Sterilization Done?

Tubal ligation for women involves a procedure of cutting or tying the fallopian tubes. For men, it involves cutting or tying the vas deferens, the passageway for sperm. It is called vasectomy.

Female Sterilization-Tubal Ligation

During the reproductive cycle of women, ovulation happens around every month. During this time, an egg is released from the ovary into the fallopian tube. Sometimes, more than one egg is released. The egg travels down the fallopian tube on its way to the uterus. In tubal ligation, the tubes are either cut, tied, or sealed, so that the egg cannot meet sperm. This prevents fertilization from occurring.

For women, tubal ligation can be done in several ways. It can be either be done laparoscopically through small cuts on the abdomen, hysteroscopically by inserting a scope through the vagina into the uterus, or though minilaparotomy via incisions on the abdomen. If you are pregnant, you can choose to have a tubal ligation right after you give birth. This procedure is called postpartum tubal ligation. If you plan to give birth through Cesarean section, you can choose to have a tubal ligation done at the same time, through the same incision. A Houston Gynecologist can help you decide the best approach for you.

Usually, a tubal ligation is effective right after the procedure, except for procedures done via hysteroscope. With this method, it is necessary to wait 3 months after the procedure for follow-up. An x-ray is done after this period to see if the tubes have become really blocked.

Tubal ligation is a surgical procedure, and like any other surgery, it carries a small risk of some complications happening. But with today’s technology, serious complications have become very rare, and most of the time, can be easily treated.

Tubal ligation is quite effective at preventing pregnancy. Less than 1% of women get pregnant after undergoing tubal sterilization. For these women, however, the risk of having an ectopic pregnancy is higher.


Male sterilization involves sealing the vas deferens by cutting, tying, or clipping it. The vas deferens is the passageway for sperm from the testes into the urethra to be expelled during ejaculation. Blocking the vas deferens prevents release of sperm, and consequently, prevents fertilization from occurring.

Vasectomy procedures can be done easily in a doctor’s clinic or office. The scrotum is first cleaned and then local anesthetics are applied to numb the area. The vas deferens is easily palpable through the thin skin of the scrotum. Tiny openings are made into the scrotum, and then the vas deferens is pulled through. The doctor then cuts out a small section of the loop. The remaining ends are tied or sealed using electrocautery. The heat causes fibrosis or scar tissue to form, thereby blocking the lumen of the tubes.

Compared to tubal ligation in women which are effective right after the procedure, vasectomy requires a waiting period of about 1-3 months to ensure that there are no sperm left in the tubes. Couples may have to rely on another birth control method during this time. After this period, a sperm count is done to ensure that the man’s semen is totally free of sperm.

Many men worry that their sexual performance will change or decrease after vasectomy. This is not true. Erection and ejaculation remain normal even after vasectomy. Some men also get concerned that they’re going to impregnate their partners, because there’s still ejaculate coming out upon climax. Yes, there’s still ejaculate present, because the bulk of semen is made up of fluids from the prostate gland and the seminal vesicles. Sperm cells only amount to less than 5% of the whole bulk of the semen.

Keep in mind that sterilization, whether in males or in females, or even in both, does not prevent transmission of sexually transmitted diseases (STDs). You may use condom to protect yourself against such diseases.

Sterilization, as mentioned before, is a permanent choice. If you’re not sure about this decision, you have the option of using other contraceptive measures. There are a lot of birth control options available such as hormonal birth control and IUDs. There are some methods that may not be compatible with you if you have pre-existing conditions, or have to take maintenance medications. Talk to your Houston Gynecologist about your preferences, and you can agree on which option is best for you.

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