 Hi, I'm Dr. Cheryl Dwyer, a gynecologist with Mid-Michigan Center for Women's Health. Let's talk about permanent options for preventing pregnancy. Permanent sterilization may be a good option for preventing pregnancy if you have reached the point in life where you are sure you don't want more children. It may also be your best option if you have a medical condition that makes it risky for you to become pregnant. Permanent sterilization is one of the most common forms of birth control used by 47 percent of married couples. It is available for both men and women. Permanent sterilization for women involves cutting or blocking the fallopian tubes so that sperm cannot reach the eggs. These methods often are not reversible if you change your mind and later want children. For women, permanent sterilization is generally safe and more than 99 percent effective Once the procedure is complete, it is convenient because you don't have to remember to take action every day, week or month, and it can reduce the risk of ovarian cancer and pelvic inflammatory disease. The disadvantages are increased risk for ectopic pregnancy or a pregnancy that occurs outside the uterus. Some procedures also require anesthesia, which may introduce additional risk. Sterilization does not protect you against sexually transmitted diseases or HIV AIDS. If you have multiple sexual partners, you should continue to use condoms to protect yourself during all forms of sex. One type of female sterilization is mini laparotomy. It is usually done right after a woman gives birth while the fallopian tubes are close to the abdominal wall. An incision is made and the tubes are cut or sealed with stitches, clips or bands. Female sterilization can also be done laparoscopically for smaller incisions, less pain and shorter recovery. A long thin tube called a laparoscope allows the surgeon to see into the abdomen through small incisions. Long thin instruments are used to cut the fallopian tubes and to seal them with cotteries, clips or bands. A third type of female sterilization can be done in the office using a long flexible tube called a histoscope. The tube is used to feed a tiny set of coils through the vagina and cervix into the fallopian tubes. The coils remain in place since scar tissue eventually forms around them blocking the tubes. You will need to use a backup form of birth control for a minimum of three months while the scar tissue is forming and until an x-ray confirms that the blockage is complete. If you are considering these procedures you should consult a gynecologist who will fully inform you of the risks and benefits plus what to expect before, during and after the procedure. Permanent sterilization is also available for men. This is called a vasectomy. You may want to discuss with your partner and your health care provider whether a vasectomy for your partner is the right option for the two of you. For help identifying a gynecologist who performs these procedures call the Michigan Health Line toll free at 800-999-3199.