You may decide at some point in your life that you don't want any children or that you don’t want any more. In that case, permanent sterilization may be your best option for birth control.
Therapeutic sterilization is done for medical reasons, such as cancer.
There are two ways for you to become permanently sterilized: through surgical sterilization or tubal implant. It's important that you understand that these procedures are generally irreversible.
For this method, a doctor cuts and then ties or seals your fallopian tubes, usually while you are under a general anesthetic (asleep). This keeps an egg and the sperm apart, preventing pregnancy.
In some cases, the procedure used for this is a laparotomy, in which there is a large opening in the abdomen which provides your doctor access to reproductive organs. If you are already having abdominal surgery for another reason, or want to become sterilized after a cesarean birth (postpartum sterilization), a laparotomy might make the most sense for you. 
A laparotomy might be necessary if you have certain conditions such as endometriosis or pelvic inflammatory disease, or have a lot of internal scar tissue from previous abdominal surgery. 
Surgical sterilization can also be done less invasively via laparoscopy, in which small tubes with cameras, lights and surgical instruments are inserted into your abdomen through small slits. This can be done with a local anesthetic, so that you are awake during the procedure. The recovery period from this type of surgery is usually shorter than with a laparotomy. 
Known by the brand name Essure, this is a more recent procedure in which small coils are placed into your fallopian tubes. In about 3 months, scar tissue forms around the coils, completely blocking the fallopian tubes. Eggs cannot pass through them from the ovaries, and sperm cannot pass into them from the uterus (conception takes place in the fallopian tubes).
A doctor can place your implants right in the office. It takes about 30 minutes, without surgery or general anesthesia. A hysteroscope is used to carry the coils into your fallopian tubes, after your cervix has been opened with a speculum, the same instrument used when you have your annual pap smear. You'll probably have an X-ray afterward to make sure the implants are where they are supposed to be.
Because it takes 3 months for scar tissue to adequately cover the coils and completely block your fallopian tubes, you must use another form of birth control for this period. To make sure they are blocked at this point, your doctor will inject a dye into your uterus and use an X-ray to follow it. If it leaks past the coils, then your fallopian tubes are not yet completely blocked.
After either surgical or tubal implant sterilization, you will still have menstrual cycles, but will not produce an egg that can be fertilized. Remember that these procedures will not protect you from sexually transmitted diseases.
If you have had a hysterectomy (removal of the uterus) or oophorectomy (removal of the ovaries) for another health problem, you are sterilized.
Men can also have sterilization surgery, called a vasectomy, which prevents them from releasing sperm when they ejaculate. A vasectomy is also a simple procedure done in a doctor's office, and is much less invasive than a laparotomy. If you have only one long-term sexual partner, it is another option to keep from having any more children.
By keeping your ovaries, estrogen production continues. If the ovaries are removed, premature menopause would occur, since estrogen production stops.
The American Congress of Obstetricians and Gynecologists Pamphlets on
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