First the Facts

  • Sterilisation can be performed on those with a penis (vasectomy) and those with a uterus and Fallopian tubes (tubal ligation).
  • It works by stopping the egg and sperm meeting, and therefore fertilisation cannot take place.
  • It is a permanent method of contraception, and only for those who are 110% sure there is no possibility of wanting any children in the future.
  • Some people do regret the decision, and it is important to have thought about it carefully.
  • Reversal procedures are available, but this is not always possible and, in the UK, would only be available in the private setting (at a cost of GBP 3,000–5,000).
  • Whilst awaiting the procedure, it is important to continue contraception until sterilisation is confirmed as effective.

How Does It Work and What Is Involved?

Both procedures work to create a physical blockage so that sperm and egg cannot meet, and this prevents pregnancy.

VasectomyTubal Ligation
A simple procedure performed under local anaesthetic as an outpatient.• A laparoscopic (keyhole) operation performed under general anaesthetic in hospital.
• It can also be performed at the same time as a caesarean section if you have discussed it with the surgeon prior to the operation.
A small opening is made through the scrotum and the vas deferens (tubes that carry sperm) are divided and sealed so that sperm can no longer get into the semen.The fallopian tubes (the tubes that the egg travels down from the ovary to the womb) are clipped (Filshie clips) to create a blockage, stopping the egg and sperm meeting.
• The failure rate is 1/2,000.
• Failure usually occurs if the vas deferens rejoins.
• Much less likely to fail than female sterilisation
• The failure rate is 1/200 (higher than many people think, particularly if performed at the time of a Caesarean section).
• Failure usually occurs if the ends of the fallopian tubes rejoin.
• Failure rates are higher if performed at Caesarean section or post abortion.
After the procedure you may feel slightly bruised and swollen, but this should settle quickly. Wearing supportive underwear and simple painkillers can help. • After the procedure you will likely be able to go home from hospital the same day or the next day.
• You may feel some lower abdominal pain, which should gradually settle over several days.


Schematic picture of a vasectomy

Tubal Ligation

Schematic picture of a tubal occlusion

Does It Work Straight Away?


  • Following the procedure, no unprotected sex should take place until semen analysis confirms no sperm in the ejaculate.
  • This test takes place 12 weeks after the procedure.
  • You should continue to use contraception until it is confirmed that you can stop.

Tubal Ligation

  • You will need to use contraception until your operation and for at least seven days afterwards.

What Are the Advantages and Disadvantages?


It is an outpatient procedure, performed under local anaesthetic, with a quick recovery time. Does not protect against sexually transmitted infections (you will still need to use condoms for this)
Very effective method of contraception, with a very low failure rate (1/2,000). Reversal is not guaranteed and, in the UK, is only available privately.
Avoids the need to use contraception for pregnancy prevention in the future. There is a small chance of regret, so it is important to have a discussion with a healthcare professional.
It carries lower risks than tubal occlusion for those with a womb. There are some risks associated with the procedure:
• Bleeding, swelling or infection.
• Sperm can leak out of the tube and irritate the surrounding areas.
• Chronic pain in the scrotum, testicles penis or lower abdomen. This is called chronic post-vasectomy pain syndrome and is not common. It can be treated with medication or surgery but may not always fully resolve.

Tubal Ligation

It is usually a day-case procedure, so you are discharged from hospital on the same day.The procedure is performed under general anaesthesia, which carries some risks.
Effective method of pregnancy prevention.If this method does fail, there is a higher risk of pregnancy being ectopic (outside the womb), which can be dangerous.
It is a good option for those where other choices are not available/suitable and no further pregnancies are contemplated.Does not protect against sexually transmitted infections (you will still need to use condoms for this).
Some studies have shown a decreased risk of ovarian cancer in those who have undergone tubal occlusion. Reversal is not guaranteed and, in the UK, is only available privately.
It does not affect periods in women, so you may still need an alternative method of contraception to control heavy or painful periods if this affects you.
There is a small chance of regret, so it is important to have a pre-procedure discussion with a healthcare professional.
There are some risks associated with the procedure:
• Bleeding, infection.
• Risk of damage to other structures in the abdomen during the procedure, e.g. bladder/bowel.

How Do I Arrange Sterilisation?


  • Your GP can refer you to a centre that performs vasectomies.

Tubal Ligation

  • Your GP can refer you to a gynaecologist who will discuss the procedure with you and list you for the operation.
  • If you want this done at the time of Caesarean section this needs to be discussed in advance, so let your midwife or obstetrician know when planning your operation date.

Is Sterilisation Right for Me?

  • It is important to consider whether this permanent method is right for you. Some people do regret the decision.
  • The risk of regret is higher in those under 30 years or age, those without children and those who are not currently in a relationship.
  • A healthcare professional will explore your options and discuss this with you in detail. This is not to change your mind, but to make sure you have considered your options before going ahead.
  • Some people may not be suitable for surgery due to underlying health conditions.
  • If you want sterilisation at the same time as a Caesarean section, you must discuss it in advance of the procedure.


Written by: Dr Nikki Kersey and Dr Paula Briggs
Last updated: January 2021

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