This is a frequent question from visitors to our Tubal Reversal website and Tubal Reversal Blog. There are several common reasons for asking this question after tubes have been tied. So if you have had a tubal ligation, have missed a period, and have found yourself asking the question,
“Can I be pregnant after my tubal ligation?”, then this article is for you and the answers may surprise you.
Is Pregnancy Possible After Tubal Ligation?
Pregnancy is possible after tubal ligation. Tubal ligation procedures are intended to be permanent and effective. Although tubal ligation procedure are highly effective at preventing pregnancy, pregnancies can occur after the fallopian tubes have been blocked. Tubal ligation procedures do have failures and pregnancy can occur after a tubal ligation.
Failed Tubal Ligation
A tubal ligation can fail in three ways: the fallopian tube may be missed during tubal ligation surgery and the tube may not be closed at all, the tube may form a fistula (new opening), and recanalization (rejoining of the tubal lumens) can occur.
Most times the fallopian tubes will be closed after a tubal ligation; however, if a patient has severe scar tissue it may be much harder to identify where the fallopian tubes are located. A fistula is a small opening which may remain after the healing response has been completed. This allows sperm to get through to fertilize and egg but the egg may have a harder time finding the small opening and getting back into the uterus. Recanalization occurs when the tube is not adequately closed and the tube reopens after the tubal ligation.
What Are the Chances of Tubal Failure?
The largest study to date on tubal ligation failure is the CREST study. This study found that tubal ligation failures do occur and can be as high as 3% depending on the method of tubal closure. Tubal ligation failures occured more often in women who had Hulka clip procedures and in younger women. These are the failure rates in the CREST study for the different methods of tubal ligation:
Unipolar Coagulation 0.8%
Unipolar Coagulation 0.8%
Tubal Ring 1.8%
Interval Partial Salpingectomy 2.0%
Bipolar Coagulation 2.5%
Hulka Clip 3.7%
Can You Have a Pregnancy After a Tubal Ligation?
Pregnancy can happen after a tubal ligation. A pregnancy after a tubal ligation is considered high risk because there is a greater likelihood the pregnancy will be ectopic (tubal). If a woman becomes pregnant after her tubes have been tied, she should see her doctor immediately to be evaluated for an ectopic pregnancy. Some post tubal ligation pregnancies will be inside the uterus but a large portion (30-40%) of them will be outside the uterus and in the tube. This is condition requires immediate evaluation and appropriate treatment.
Can You Have A Baby After A Tubal Ligation?
The possibility of pregnancy after a tubal ligation is very real for many women who have had their tubes tied. The chances are higher among women in their twenties and among women who have had Hulka clip tubal occlusion. The reality is women who have had their tubes tied can become pregnant after the procedure. If you have become pregnant then you should see your doctor immediately to be evaluated for a tubal pregnancy. If you want to be pregnant and have a baby then you should not rely on the failure of a tubal ligation to achieve this for you. Many women will find better and safer success in becoming pregnant after a tubal ligation though tubal ligation reversal surgery or IVF.
Submitted by Dr. Charles Monteith