What is it?
Tubal ligation is used as a form of birth control. It involves the physical disruption of the fallopian tubes. The fallopian tubes are the pathway for the egg from the ovary to the uterus. If the egg is fertilized, it can implant in the uterus and cause pregnancy. Tubal ligations prevent pregnancy by preventing contact between the egg and sperm. The egg is simply reabsorbed by the body.
A ligation reaction requires three ingredientsin addition to water:
- Two or more fragments of DNA that have either blunt or compatible cohesive (“sticky”) ends.
- A buffer which contains ATP. The buffer is usually provided or prepared as a 10X concentrate which, after dilution, yields an ATP concentration of roughly 0.25 to 1 mM. Most restriction enzyme buffers will work if supplemented with ATP.
- T4 DNA ligase A typical reaction for inserting a fragment into a plasmid vector (subcloning) would utilize about 0.01 (sticky ends) to 1 (blunt ends) units of ligase.
How is it done?
There are many methods for tubal ligations. They are classified by how they are done. The most common method is called the Pomeroy. The Pomeroy involves the creation of a loop in the fallopian tube, which is tied off. The loop is cut out. The tie is made of a material typically used in internal surgeries that the body can break down and absorb. When this happens, the two ends of the tube fall apart. The danger is that they will re-attach, or the egg or sperm can cross the gap, resulting in a regular or more likely an ectopic pregnancy. This is why two other procedures, the Irving and the Uchida, move the ends of the tubes away from each other. There are also devices that block the tubes. The Hulka clip and the silastic falope ring are used to clamp the tube.
Tubal ligation typically involves an incision in the abdomen, usually under the belly button. A small incision of about a half an inch or simply a few circular areas the size of a pencil eraser. In the not too distant future, expect to see office procedures that will go in through the vagina and cervix and plug or otherwise disrupt the tubes.
Risks:While major complications are uncommon after tubal ligation, there are risks with any surgical procedure. Possible side effects include infection and bleeding. After laparoscopy, the patient may experience pain in the shoulder area from the carbon dioxide used during surgery, but the technique is associated with less pain than mini-laparotomy, as well as a faster recovery period. Mini-laparotomy results in a higher incidence of pain, bleeding, bladder injury, and infection compared with laparoscopy. Patients normally feel better after three to four days of rest, and are able to resume sexual activity at that time.
The possibility for treatment failure is very low—fewer than one in 200 women (0.4%) will become pregnant during the first year after sterilization. Failure can happen if the cut ends of the tubes grow back together; if the tube was not completely cut or blocked off; if a plastic clip or rubber band has loosened or come off; or if the woman was already pregnant at the time of surgery.
Side effects of tubal ligation reversal surgery may include:
- Damage to the surrounding organs
- Complications due to anesthetic
Thanks to the advances made in microsurgery, though, it is possible for tubal reversals to be done in less than an hour on an outpatient basis. Additionally, only local anesthesia is necessary for this procedure. While this type of surgery is far less invasive than the traditional tubal ligation reversal surgery, thereby significantly reducing the risk of complications, the technology is still new and not widely practiced.
Advantages in India
- Permanent birth control.
- Immediately effective.
- Allows sexual spontaneity.
- Requires no daily attention.
- Not messy.
- Cost-effective in the long run.
- Does not protect against sexually transmitted infections, including HIV/AIDS.
- Requires surgery.
- Has risks associated with surgery.
- More complicated than male sterilization.
- May not be reversible.
- Possible regret.
- Possibility of Post Tubal Ligation Syndrome