Female Sterilization

Effectiveness: Nearly 100 percent (less than 1 pregnancy per 100 women each year).

What is it?It is an out-patient procedure to block, close or cut fallopian tubes to prevent eggs from traveling up the tubes, thereby preventing fertilization. The traditional form, tubal ligation ("getting your tubes tied"), involves surgery to tie and cut or seal the tubes. The tubes can be sealed with an electrical current, clips, clamps or rings. Surgical sterilization is effective immediately. The newer technique (Essure) involves putting tiny inserts in the tubes that cause tissue to grow around them and block the tubes; it takes about 3 months for this form to become effective, and your health care provider will check to make sure your tubes are blocked.

How does it work? Sterilization permanently blocks the fallopian tubes so the sperm cannot reach the egg.

STD protection: No; you will still need to use condoms if you are concerned about STDs.

Benefits: It can be an excellent choice with few side effects if you are finished having children or don't plan to have children. It is convenient and permanent, so you won’t have to worry about birth control any more.

Disadvantages: It is considered permanent. The surgical sterilization carries the typical risks of surgery, such as reaction to anesthesia, and involves a recovery period. There have been numerous complications reported to the U.S. Food and Drug Administration since Essure was released in 2002. In 2016, the FDA ordered changes in the package labeling for Essure to include a boxed warning and a "patient checklist," both designed to ensure that women understand the risks and benefits of the device. The FDA is also requiring the manufacturer of Essure to conduct a clinical study to determine risks of Essure for particular women. Always talk with your health care provider about your personal risks and benefits.

Availability: Sterilization must be done by a doctor. It can be performed in a medical office, clinic or hospital

Cost: $1,500 to $6,000; generally costs more if performed in a hospital. It may be covered by insurance.*

Notes: Because sterilization is meant to be permanent, there may be state or federal requirements, such as waiting periods or age restrictions. Some doctors may not be willing to sterilize young women with no children.

* The Affordable Care Act requires insurance companies to cover with no co-pay any FDA-approved contraceptive method prescribed by your doctor, including barrier methods, hormonal methods, implanted methods, emergency contraception, female sterilization and patient education and counseling. These estimated costs apply to women who do not have insurance coverage or who work for a "religious employer," who may be exempt from providing contraceptive coverage. For details about what your insurance covers, contact your benefits coordinator or health insurance provider.