Transcervical Hysteroscopic Sterilization

Transcervical hysteroscopic sterilization is a procedure performed to permanently prevent pregnancy. Transcervical means the procedure is done though the cervix, so no cut (incision) is needed. Tiny coils (microinserts) are placed in the fallopian tubes. After the microinserts are placed, scar tissue forms in the fallopian tubes. The scar tissue will not allow an egg to reach the uterus. If an egg cannot reach the uterus, sperm cannot fertilize it.   

You must be very sure you do not want to get pregnant. Deciding to have a permanent sterilization is a big decision. Take your time and do not decide under stress. Women who make this decision before age 30 also tend to have later regrets. Talk about the procedure with your partner.

Things to know:

  • This procedure is not considered effective birth control for at least 3 months.

  • You will need an additional procedure (hysterosalpingiogram, HSG) to confirm the tubes are blocked.

  • You will need to use another form of birth control for at least 3 months.

  • If your tubes are not blocked after 3 months, you will need to talk with your caregiver about options.

LET YOUR CAREGIVER KNOW ABOUT:

  • Gynecological history, including previous gynecological surgeries or procedures, recent pregnancies, and previous birth control use, including pills and intrauterine devices (IUDs).

  • Allergies. This includes any problems or reactions to metals.

  • All medicines you are taking including vitamins, herbs, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or as creams).

  • Previous problems with numbing medicines.

  • Previous bleeding problems.

  • Previous surgeries.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy.

  • Recent pelvic infections.

RISKS AND COMPLICATIONS

  • A hole (perforation) in the uterus or fallopian tube.

  • Allergic reaction to the coils used to block the fallopian tubes.

  • The coil falls out (extrusion).

  • Infection.

  • Bleeding.

  • Chronic or acute pelvic pain.

  • Painful menstrual periods.

  • A pregnancy that grows inside a fallopian tube instead of the uterus (ectopic pregnancy).

  • One or both fallopian tubes are not fully blocked.

BEFORE THE PROCEDURE

  • You may need to have a pregnancy test.

  • Ask your caregiver about changing or stopping your regular medicines.

  • You may need to keep track of your menstrual cycle. This procedure works best when it is done about 7 days after your period starts.

  • Talk to your caregiver about birth control.

  • If you are not using birth control, you may need to start 2 to 3 weeks before the procedure. This makes the procedure easier and ensures that you are not pregnant.

PROCEDURE

This procedure takes about 30 minutes. It may be done in your caregiver's office or in an outpatient clinic.

  • You will be awake during the procedure.

  • You may be given a medicine to numb your cervix (local anesthetic).

  • A long, thin telescope with a camera (hysteroscope) will be put into your vagina, then through your cervix, and into the uterus.

  • The openings to both fallopian tubes are seen with the hysteroscope.

  • Through the hysteroscope, microinserts are put into the fallopian tube openings. They unwind once they are in place. They do not block the openings to the fallopian tubes, but over time, the microinserts will scar the tubes shut.

AFTER THE PROCEDURE

  • You may be able to go home right away.

  • You may have mild cramps.

  • You may have some mild bleeding or discharge from your vagina for a few days.

  • In 3 months, you will need to have an X-ray taken. This test is done to make sure your fallopian tubes are completely blocked.