This is surgery to take out both of your fallopian tubes. Your ovaries stay in place. It may be done to prevent ovarian cancer.

For years, doctors thought that most ovarian cancers started in the ovaries. Research now shows that many high-grade ovarian cancers (the most common and serious form) start in the cells of the fallopian tubes.

This has changed how doctors think about prevention. Removing the tubes, even when the ovaries are left in place, can lower the risk of getting this type of cancer for those who have an average risk.

This surgery lowers ovarian cancer risk, but it doesn't remove it completely. A small number of cancers start in the ovaries rather than the fallopian tubes.

This is cancer that starts when cells in or near the ovaries grow out of control. It can be harder to catch early because symptoms are often hard to notice. Or symptoms may not appear until the disease has progressed.

The option to remove the fallopian tubes often occurs in two ways.

• You're already having another pelvic surgery, such as a hysterectomy. You may choose to have your tubes removed at the same time.
• You want permanent birth control. Removing the tubes can be done as a means of permanent birth control that also lowers ovarian cancer risk.

If you have an average risk of ovarian cancer, studies show that taking out the tubes can lower your risk by roughly half. For those who have a high genetic risk, doctors usually suggest taking out the ovaries and the tubes.

The things that can raise your risk of ovarian cancer are:

• A family history of ovarian, breast, or related cancers.
• Inherited gene changes. These include changes to the BRCA1 and BRCA2 genes.
• Getting older, since risk rises with age.
• Certain personal health factors your doctor can review with you.

Talk to your doctor about your risk. If you have one or more of these risk factors, you may want to have genetic counseling or more screening.

Like any surgery, it has some risks. These include bleeding, infection, and reactions to anesthesia. Your doctor will talk with you about these risks based on your health history.

Because your ovaries stay in place, this surgery doesn't affect your hormone levels. It also doesn't cause surgical menopause the way that taking out the ovaries would.

This surgery is a form of sterilization, so you won't be able to get pregnant on your own afterward. Pregnancy may still be possible through in vitro fertilization (IVF). Talk with your doctor about fertility options before surgery.

Both are forms of permanent birth control, but they work in different ways.

• Tubal ligation blocks, cuts, or seals the fallopian tubes. The tubes stay in your body.
• Bilateral salpingectomy removes the tubes.

Research suggests that taking out the tubes may lower cancer risk more than tubal ligation. If you're already open to permanent birth control, you may want to discuss this with your doctor.