Tubal occlusion

Tubal occlusion is a permanent method of birth control for women. It is achieved by an operation to permanently block both fallopian tubes. This prevents sperm from fertilising an egg

Tubal occlusion is an operation carried out to permanently prevent pregnancy in biologically female patients. It is considered a form of female sterilisation. 

The procedure works by preventing eggs from travelling down the fallopian tubes and into the uterus. In doing so, it means that a person’s eggs cannot meet sperm cells, preventing fertilisation and therefore pregnancy. Eggs will still be released every month as part of a patient’s menstrual cycle, but these will be absorbed naturally into the body. 

A surgeon will carry out a tubal occlusion by either:

  • Applying clips; plastic or titanium clamps are closed over the fallopian tubes
  • Applying rings; a small loop of the fallopian tubes are pulled through a silicone ring, before being clamped shut
  • Tying, cutting, and removing a small piece of the fallopian tube

The operation itself is considered fairly minor and many patients will be allowed to return home the same day.

A GP may recommend that a patient undergo counselling before referring them for any type of sterilisation procedure. This will give them a chance to talk about the operation in detail, and to discuss any worries or questions that they may have. It is also recommended that patients who have partners discuss the decision to have the operation with them before it is carried out. It is not a legal requirement to get your partner’s permission, but you should both agree to the procedure where possible.

If a doctor agrees to a patient’s decision to be sterilised, the patient will be referred to a gynaecologist for treatment.

During the tubal occlusion procedure, the surgeon will access the patient’s fallopian tubes by making a small incision in one of two places. This may either be near the navel if the operation is a laparoscopy, or just above the patient’s pubic hairline if the operation is a mini-laparotomy. After this, they will insert a laparoscope, a long, thin instrument that has both a light and a camera, so that they can see the patient’s fallopian tubes.

A patient will need to use contraception as birth control until the day of the operation and right up until their next period after the surgery. Their sex drive and sex life should not be affected, and they should be able to have sex as soon as they feel comfortable. Sterilisation does not protect against sexually transmitted diseases or infections, however, so they may still need to use condoms.

Laparoscopies will ordinarily be performed because they are faster procedures, but mini-laparotomies may be recommended for patients who:

  • Are obese
  • Have a history of pelvic inflammatory disease (PID), which is a bacterial infection that can affect the womb and fallopian tubes
  • Have had recent abdominal or pelvic surgery

If blocking the fallopian tubes does not work, a doctor may suggest that a patient’s tubes are completely removed instead. This is known as a salpingectomy.

Almost any biological female patient may be sterilised through tubal occlusion, but the procedure should only be considered by those who already have children or do not want children at all. Once the procedure has been carried out it is very difficult to reverse and the process of reversal is not usually available on the NHS.

A person is more likely to be accepted for the operation if they are over the age of 30 and already have children, though this does not mean that others will always be denied.

Tubal occlusion can be performed at any stage in a person’s menstrual cycle, but experts will ask that they take a pregnancy test first. This ensures that the patient is not pregnant, because once they have been sterilised there is a high risk that any pregnancy will become ectopic.