Understanding Tubal Ligation

Understanding fallopian tube anatomy and which tubal ligation procedure your physician used for sterilization will better help you decide if tubal reversal surgery is right for you.

Tubal ligation is the general term for any surgical procedure that blocks the fallopian tubes to prevent pregnancy. Sperm enter the fallopian tube through the uterus, and eggs enter from the ovarian or fimbriated end of the tube. When the fallopian tubes are blocked, sperm and eggs are kept apart and conception is prevented. Ligation means "to tie", and tubal ligation is often called "tying" the tubes. Many people picture tying a fallopian tube like tying a shoe lace or a bow, and wonder why the tube can't simply be untied to restore fertility.

The fallopian tube is a narrow muscular organ arising from the uterus and ending just next to the ovary. It is about the diameter of a pencil. The inner tubal lining is rich in cilia, the microscopic hair-like projections that beat in waves and move the egg to the uterus. The normal fallopian tube is about 10 cm (4 inches) long and consists of several segments. Starting from the uterus and proceeding toward the ovary, these are the:

• Interstitial segment -- passes through the uterine muscle
• Isthmic segment -- narrow muscular segment by the uterus
• Ampullary segment -- wider middle segment
• Infundibular segment -- funnel shaped segment near the ovary
• Fimbrial segment -- ciliary lining facing the ovary

Different doctors use different methods for tubal ligation. The particular method of ligation used by your physician will be specified in the tubal ligation operative report that your operating physician will have in his or her records. Several of the most popular methods of tubal ligation procedures are:

• Pomeroy Technique
• Tubal Rings and Clips
• Monopolar and Bipolar Tubal Coagulation
• Parkland and Irving Procedures
• Fimbriectomy