These are very common questions from women who have had their tubes tied.
Many women will have missed a period after a tubal ligation and are fearful they may be pregnant. Others will desire to have another child and wonder what are their chances of becoming pregnant after a tubal ligation.
Women have many different reasons to become concerned about the possibility of pregnancy after a tubal ligation.
Tubal ligation failure is a very real possibility for many women; however, the failure of the tubal ligation is never because their tubes have become ‘untied’ and never because their tubes have ‘grown back together’. The real reasons for pregnancy after tubal ligation are shared with readers below.
Can my tubes come untied?
Can tubes come untied? The simple answer is tubes can not become untied.
Why? Because they are never just ‘tied’ to prevent pregnancy. Many people believe the tube is tied like a piece of rope to prevent pregnancy. Others believe the tube is tied with a piece of string and once the string is removed then pregnancy will happen.
Tubal (fallopian tube) ligation (to tie) is an incorrect medical term which has been perpetuated by the medical community. Society has picked up on this term because it is easier to understand and easier to convey meaning.
Rather than say to your doctor, “I would like a bilateral fallopian tubal occlusion sterilization procedure“, it is much easier to request, “Please tie my tubes!”
Can I get pregnant after my tubes are cut and tied?
When you undergo a tubal ligation and resection procedure the tubes are cut and a small piece is removed from each tube. Cutting a segment of the tube out removes a small part of the pathway for the sperm to meet the egg.
Suture is then tied around the cut ends. The purpose of tying the ends with a suture is to prevent the cut ends from bleeding. The suture is intended to dissolve. Occasionally, when the tubal ends heal they may heal with a small opening.
This small opening is called a fistula and can easily let sperm out of the tube but it is much harder for a fertilized egg to finds its way to the small opening, inside the tube, and safely to the cavity of the uterus.
To better understand this concept it is helpful to imagine a funnel. It is much easier for small sperm to get through the funnel from the wider end and much more difficult for the larger egg to both find and get through the narrower side. Often this will be chemical pregnancies (early miscarriages detected by pregnancy tests only) or ectopic pregnancies.
Pregnancy can happen after any female sterilization procedure and it is estimated that 1-2 per 100 women may experience a failure of their tubal ligation. Occasionally these will be normal pregnancies but many times they will be ectopic or tubal pregnancies.
Can my tubes grow back together?
Tubes can not grow back together but they can heal with a fistula or the inside of the tube may not be fully closed.
Inadequate tubal closure occurs more commonly with tubal coagulation procedures, but can also occur with ring and clip procedures. During these tubal procedures, the doctor may not have applied enough heat energy to fully close the tube. Sometimes with a healthy blood supply this partial opening can result in pregnancy.
So technically tubes can not grow back together, but they can be poorly or inadequate closed or separated during the tubal ligation procedure.
Can I get pregnant after a tubal?
Pregnancy can happen after a tubal. Many women will miss a period after a tubal ligation procedure and naturally their first concern will be if they are pregnant. Skipping periods is abnormal and is likely due to hormonal imbalances.
Some women wonder if they can get pregnant after a tubal because they have changed their minds about their tubal procedure and want to know what the alternatives are for getting pregnant after a tubal ligation operation.
Only a small percentage of women will become pregnant naturally after their tubes have been tied. This is because of tubal failure. Although a few women will have a normal pregnancy many will have an ectopic pregnancy which will need urgent evaluation and treatment.
How can tubes come untied?
How can my tubes become untied? They only way to have your tubes become untied is to have a tubal ligation reversal procedure. At Chapel Hill Tubal Reversal Center, we have extensive experience with tubal reversal surgery and over 98% of patients who come to us can have at least one tube successfully ‘untied’. Over 70% of these patients will experience pregnancy success.
Submitted by Dr. Charles Monteith