Tubal ligation: FSA Eligibility

Revenue Ruling 73-201; Revenue Ruling 73-603

What is a tubal ligation?

Tubal ligation is a sterilization procedure. Sterilization is a permanent method of birth control. Sterilization for women and men involve different procedures. For women, sterilization is normally performed via a procedure called tubal occlusion. For men, sterilization is normally performed via a procedure called vasectomy. Tubal occlusion closes off a woman's fallopian tubes so that her eggs cannot travel from her ovaries into her uterus. Because her eggs cannot reach her uterus, and sperm cannot reach her eggs, the woman can no longer become pregnant. Similarly, with a vasectomy, the man's vas deferens are closed off to prevent sperm traveling from the testicles to the urethra and beyond (WebMD).

Success rates for sterilization procedures very. Vasectomies have a slightly lower success rate than tubal occlusions. Both procedures are subject to the possibilities of inaccurate surgical procedures, regrowth or healing, etc. Tubal occlusions have been studied and result in fewer than 1 in 100 patients becoming pregnant after the procedure. Vasectomies are more difficult to study in non-monogamous situations, but are studied to be slightly less effective, or to result in slightly more pregnancies (Urology Care Foundation).

Sterilization is not meant to be reversible, though there are surgical procedures that attempt to re-link the vas deferens or fallopian tubes in an individual who has decided to attempt to reverse their sterilization. These procedures are not always effective. They may also not be covered by insurance, necessarily. Scar tissue and other complications of healing and surgery are possible reasons that a sterilization reversal might fail.

Costs of undergoing a sterilization procedure for men or women are both considered eligible for reimbursement with a consumer-directed healthcare account.