October 11, 2024, 8:02 am | Read time: 6 minutes

If fertility planning has been completed or is not available at all, female sterilization may be an option in addition to the pill, hormone injections, or other contraceptive methods. STYLEBOOK explains how and when the procedure makes sense, what the risks are, and what the costs are.

TV personality Daniela Katzenberger has only recently admitted this: She has undergone female sterilization. According to a study, female sterilization is not one of the most commonly used contraceptives, but it is playing an increasingly important role for many. The procedure is performed in a hospital under general anesthesia and can take place at any time – regardless of whether you are on your period or not. For gynecologists, this is a routine procedure in the United States. Nevertheless, every operation and every general anesthetic carries risks such as internal bleeding, organ injuries, or allergic reactions. We have summarized what you need to know about sterilization as a woman with the help of Dr. Mandy Mangler, head physician at the Auguste-Viktoria Clinic for Gynaecology and Obstetrics in Berlin.

How does the procedure work?

The actual sterilization procedure only takes 10 to 15 minutes, with three punctures, a camera, and two surgical tools being inserted into the abdominal cavity. This means that three small scars remain on the abdomen later. Both fallopian tubes are severed for sterilization. To ensure that they do not grow together, a piece of the fallopian tube is removed. In the past, it was common practice to simply cauterize the fallopian tubes after cutting them – a procedure that has not proved successful. You should, therefore, definitely ask your doctor before the procedure whether he or she will also remove a piece of the fallopian tube.

How risky is sterilization for the woman?

Although the procedure only takes a few minutes, you can expect to spend several hours in the hospital due to the preparation for the general anesthetic and the waking-up phase. If your circulation is stable, you can leave the hospital on the same day. After sterilization, you can do everything again straight away – including sexual intercourse. If your abdomen is too sore or you are very sensitive to pain after the procedure, you may need to stay at home for a day or two. However, it is neither necessary nor advisable to rest excessively.

Sterilization has no effect on your menstrual cycle, libido, or menopause. In extremely rare cases, ovarian function may be disrupted, which can upset your hormone balance. The risk is 1:200,000, and this usually passes.

Pregnant despite sterilization: is it possible?

Pregnancy after sterilization is extremely unlikely and basically only possible if the procedure was performed incorrectly. In the past, when people were not yet so well versed in the field of surgery, this actually happened from time to time. Instead of cutting the fallopian tube, the so-called mother ligament, which is located near the fallopian tube and looks similar, was cut. It is almost impossible for something like this to happen today.

The woman almost always bears the costs

You usually have to pay for sterilization yourself; the procedure costs up to 1000 euros. If you have a serious illness and are not allowed to take the pill due to an increased risk of thrombosis or pulmonary embolism, you can try to get sterilization covered by your health insurance as a contraceptive. However, the costs of sterilization are covered if the procedure is carried out as part of a cesarean section.

Sterilization: A question of age?

Sterilization is generally possible from the age of 27. Of course, there are exceptions where it is possible earlier. However, this should be very well justified if, for example, all other contraceptive methods are out of the question due to a serious illness, and you have to prevent pregnancy at all costs. The gynecologist will have a detailed discussion with anyone under the age of 35. The doctor may also ask for a psychological assessment. This serves as a safeguard for the doctors – in case the woman regrets the sterilization afterward. Every woman should, therefore, think carefully about this procedure.

Can I reverse a sterilization?

It is possible to become pregnant after sterilization. The woman is still fertile after the procedure – but she can no longer become pregnant naturally, as the sperm can no longer reach the ovaries due to the severed fallopian tube. However, artificial insemination is still an option. However, this is associated with costs that you will have to bear yourself. This is also the case if you want to reverse the sterilization. This is called “re-fertilization,” i.e., “fertility restoration.”

During the procedure, the fallopian tube is rejoined. The chances of success are 50:50. The fallopian tube is very susceptible to internal scarring. It is, therefore, not easy to completely reconstruct the fallopian tube and make it permeable again. The procedure is not dangerous, but it is much more complicated than sterilization and, therefore, takes a little longer. The patient must bear the cost of 1,500 euros.

These complications can occur

Complications are extremely rare with sterilization. You don’t have to worry about spotting either, as the procedure does not disrupt the uterus. Nevertheless, as with any operation, there are some risks for the woman during sterilization. For example, bleeding, inflammation, or wound healing disorders can occur. In rare cases, blood vessels in the surrounding tissue can also be damaged when the fallopian tubes are obliterated. The blood supply to the fallopian tubes and their hormone production can be impaired in this way. In the first 10 years after the procedure, there is also a small risk of ectopic pregnancy. However, this is extremely rare.

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When is sterilization advisable for women?

For people who have completed family planning, sterilization is the ideal contraceptive method. The fact that contraception is often still a woman’s issue is shown by the fact that ten times more women than men undergo sterilization. The procedure for men, known as a vasectomy, is much simpler and less risky, as it does not require general anesthesia, just local anesthesia. As with women, the male vas deferens (also called a sperm duct or a ductus deferens) is severed and a small section cut out. The costs are lower than for female sterilization at 300 to 400 euros.