Tubal ligation, or sterilization, remains the top contraceptive choice of American women with about 28 percent of women who practice birth control choosing this method. Commonly referred to as "getting your tubes tied," the process involves cutting, burning, or blocking the fallopian tubes with rings, bands, or clips. When the tubes are closed, the egg cannot travel from the ovary into the uterus. Tubal ligation is irreversible and is 98-percent effective.
There is a less invasive alternative to having your tubes tied called an hysteroscopic tubal sterilization. It works by threading a tiny, spring-like device through the cervix and into each fallopian tube. The insertion of this device (called Essure) takes 30 minutes, about one-quarter the time of traditional sterilization, and can be done in a doctor's office. Because there's no surgery involved, recovery time is much shorter than with a tubal ligation. Like a tubal, this procedure is considered to be irreversible and is 99.8-percent effective in preventing pregnancies. A follow-up X-ray is done to make sure the tubes are closed.
Vasectomies are a man's version of sterilization. Like tubal ligations, vasectomies block tubes, are considered to be irreversible, and are nearly 100-percent effective. With this procedure, the vas deferens—two tubes that carry sperm—are blocked. Unlike tubals, vasectomies are not immediately effective because sperm can remain in the system beyond the blocked tubes. Back-up birth control is necessary until a semen analysis shows that the seminal fluid is free of sperm.