The sterilization is a definitive female contraception procedure with 99% efficiency to avoid unwanted pregnancies, however, if the woman regrets it, the chances of reversing the procedure are low. Below, learn all about this process, such as the advantages, disadvantages, recovery, and other information.

For this, we talked to Dr. Rita de Cássia Alam Machado, gynecologist and obstetrician, who coordinates the Women's Health Diagnostics at Salomão Zoppi.

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What is a sterilization?

According to the specialist, tubal ligation is a surgical process where the uterine tubes have their anatomic path interrupted, with the main objective related to contraception, that is, voluntary infecundity.

"It is a safe method, highly effective and generally permanent, so it is important to think long and hard about the method, so much so that the law provides for a minimum interval of 60 days between the manifestation of the desire and the surgical act itself," indicates the gynecologist.

Therefore, in this moment of reflection, it is important to remember the existence of other methods of contraception that are reversible and also highly effective.

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How is the sterilization process performed?

According to the obstetrician, tubal ligation is a simple surgery, whose main objective is to interrupt the meeting between the gametes inside the uterine tube.

"There are several techniques to cause this obstruction, from cutting the tubal ligature, cauterization, use of ring to clip. The procedure can be done through a direct incision in the abdomen or through laparoscopy," he informs.

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Exams required to perform the procedure

To have a sterilization, it is necessary to do pre-surgical exams that may vary according to the woman's health profile. However, Dr. Rita says it is common to request simple lab exams, serologies, and cardiologic evaluation.

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How is the recovery?

The abdominal laparotomy ligature cases may present risks of a post-surgical similar to a c-section, such as the dangers of infection at the site and hematoma, as well as some internal bleeding. However, this phase of the post-laceration recovery can be five days on average.

When the surgery is done vaginally or laparoscopically, the recovery is more relaxed, around one to two days in the hospital, if there are no complications. Thus, in one week, the patient is already well and can return to her normal routine.

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Sterilization through SUS and health insurance

To have a sterilization performed by SUS, the woman must go to a basic health unit (UBS) and request the procedure. The appropriate documentation must be filled out and the patient will be referred to a multidisciplinary group that will guide her about the procedure and the possibility of other methods.

If the decision to perform a sterilization is maintained, she will be referred to the hospital network where she will await the possibility of performing the procedure.

"If after all this information, the couple or patient wishes to undergo a sterilization, it can be done either through SUS or health insurance plans, since this procedure is expected to be covered by the plans (law 9.656/98)", comments the consulted specialist.

In the private/contract service, all the information must be given to the woman or couple, as in the SUS, and, if the desire for the procedure is maintained, the surgical intervention can be performed in hospitals accredited in the plan, after this legal procedure.

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What is the minimum age for sterilization?

Many women have doubts about the minimum age for sterilization, and so it is important to know that tubal ligation is foreseen in the Ministry of Health's Family Planning Law (federal law 9.263/96).

This law states that sterilization is allowed in women over 25, who have at least two living children, or when there is a risk to the life of the woman or the unborn child in future pregnancies.

"During the gestational period, evolving to delivery or abortion, the sterilization can only be performed if there is maternal risk in future pregnancy, for example, when the patient already has multiple cesarean sections. When there is no maternal risk, the sterilization can only be performed after the 42nd day after delivery or abortion," exemplifies the gynecologist.

Finally, to perform this procedure, it is usually requested that the patient sign an informed consent form, which will contain the main information about the method and clarify the possibility of using other contraceptive methods.

"When there is a so-called conjugal partnership, there is a need for the partner's agreement, and he or she must also sign the request for definitive contraception," he adds.

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After all, what are the advantages and disadvantages of sterilization?

Although tubal ligation is the most effective method, after all, it has an effectiveness of about 99%. In other words, this means that one woman out of every 100 who undergoes the procedure gets pregnant. However, the medical literature reports a failure rate of 0.41% due to possible formation of a fistula or recanalization of one of the tubes.

See the advantages of the method:

• The failure rate is minimal;
• It does not interfere with the libido;
• The woman does not have to remember to take the contraceptive;
• It does not introduce hormones into the body;
• It does not cause side effects in other organs;
• Savings related to possible expenses with other contraceptives;
• It does not interfere with the breastfeeding process;
• Very few complications arise from the surgical performance of this procedure.

Disadvantages of tubal ligation:

• Repentance of the procedure in the future;
• It is very difficult to reverse, but it is possible to have a sterilization reversal surgery and be successful;
• As with any surgical procedure, there can be complications, such as adhesions and internal infections;
• It is a surgical procedure with anesthetic risks;
• There is the possibility of developing post-lactation syndrome, in which case there is altered menstrual flow and pain in the pelvic region.

However, Dr. Rita points out that because it is a simple surgery, complications are uncommon: "cases of infection or bleeding may occur, or eventual allergy to the anesthetic used," she says.

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Is it possible to get pregnant even if I have had a sterilization?

Finally, the obstetrician comments that in cases of post-laceration regret, it is possible to try to reverse the procedure: "The chances of success will depend on the general aspect of the fallopian tubes and the technique used in the surgery. in vitro ".

Source: Dr. Rita de Cássia Alam Machado, gynecologist and obstetrician, who coordinates the Women's Health Diagnostics at Salomão Zoppi.