Is it Possible to get Pregnant after a Tubal Ligation?

It's possible to get pregnant after tubal ligation. Sometimes it occurs naturally because the procedure fails. In other cases, reversal surgery is possible. Learn more in this article!
Is it Possible to get Pregnant after a Tubal Ligation?

Last update: 12 August, 2021

Tubal ligation is a permanent method of contraception. Although a reversal procedure’s possible, it’s complex and not always successful. Therefore, the possibility of getting pregnant after tubal ligation decreases greatly.

This method involves cutting, “tying,” or blocking the Fallopian tubes. Therefore, it prevents both the egg and sperm from moving into the tubes themselves, making fertilization unfeasible.

Tubal ligation is a method of female sterilization. It’s safe and effective in preventing conception, but one in 100 women may become pregnant after tubal ligation naturally.

Tubal Ligation Reversal

A doctor talking to a woman about getting pregnant after tubal ligation.
If you want to become pregnant after tubal ligation, you should talk to your health care provider about reversal surgery.

Generally speaking, tubal ligation is performed to permanently prevent pregnancy. However, there’s a surgical procedure to reverse it, but it’s quite complex and can also be very expensive. In addition, it doesn’t always work.

The reversal procedure’s possible depending on how the tubal ligation took place, how it healed, and when it occurred. The less damage to the Fallopian tubes, the greater the possibility of reconstructing them surgically.

Likewise, the areas of the Fallopian tubes close to the ovary need to have remained intact and they must have a minimum length of one and a half inches. If the technique the surgeon used was cauterization or what doctors call the Essure procedure, reversal’s impossible.

The easiest reversal procedure takes place when tubal ligation was performed with tubal clips or tubal rings. Just the same, in all cases, a physician should evaluate the benefits and possible harms of the reversal procedure. They should also discuss other possibilities such as in vitro fertilization.

In vitro fertilization

When reversal’s impossible or unpromising, a good alternative way to get pregnant after tubal ligation is to resort to in vitro fertilization. This is a common treatment and there’s a chance of achieving pregnancy in 50-70% of cases.

With in vitro fertilization, there’s no longer a need for Fallopian tubes. This procedure allows the harvesting of the eggs from the ovary, fertilization, embryo culture, and implantation of the embryo in the uterus.

You may also be interested in: 7 Tips for Getting Pregnant

For a woman to decide whether the best option to achieve pregnancy is tubal ligation reversal, when possible, or in vitro fertilization, she and her doctor need to take into account some considerations such as the following:

  • Age: A woman under 35 years of age has a greater chance of getting pregnant naturally, but this is only 15%. If she’s over 40 years old, the probability is 5% and she also has a 40% risk of miscarriage.
  • Male fertility: It’s important to make sure that the partner’ fertile. Otherwise, a pregnancy would be impossible in a natural way.
  • Future contraception: If the woman only wants to have one child, she may have to think about in vitro fertilization. Only if she wants to have more children is tubal ligation reversal worthwhile.

Possibility of ectopic pregnancy

An ectopic pregnancy occurs when fertilization of the egg takes place but it implants in a place other than the uterus. Most commonly, it implants in a Fallopian tube. In these cases, the fertilized egg can’t survive and, in addition, there’s a risk of severe internal bleeding.

Studies show that up to a small percentage of women with tubal ligation become pregnant (approximately 1.5 %). Within this group, an ectopic pregnancy occurs in about one-third of them.

When there’s a tubal ligation reversal, there’s also a risk of ectopic pregnancy. This occurs in between 10 and 20 % of women who’ve had this procedure.

At the same time, women must take into account the possibility of heterotopic pregnancy. In this case, there’s a fertilized egg inside the uterus and another fertilized egg outside the uterus simultaneously. It’s very rare, but the chances of heterotopic pregnancy are 0.5 to 1 % higher with the use of assisted reproductive technologies, such as in vitro fertilization.

When to seek medical help

A woman experiencing lower abdominal pain.
In the presence of discomfort after tubal ligation or tubal reversal, you need to see a doctor.

Any abnormal sign after a tubal ligation or tubal ligation reversal procedure should be reported to your physician. Be especially attentive to signs such as swelling, redness, or discharge at the incision site.

Suspected pregnancy can be resolved with a home test. However, the doctor has the possibility of performing additional tests to confirm pregnancy. You need to know the symptoms of ectopic pregnancy very well and seek medical help if they occur.

Tubal ligation reversal: Conclusions

It’s important to carefully evaluate the best option for getting pregnant after tubal ligation. According to the available data, the maximum success rate of reversal is in the range of 60-80 % in those under 35 years of age who’ve had the ligation more than two years before and meet the criteria.

In vitro fertilization, on the other hand, has a success rate of up to 70 % in healthy women under 35 years of age. This is achieved after one year of treatment.

As you can see, women and their doctors must take all the factors that come into play into account and decide as to which is the best option in each case.

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