Most women are told their tubal ligations are permanent and irreversible. Many women will regret having had a tubal sterilization and will be unaware about the possible ways to to conceive after a tubal ligation.
There are 3 ways to become pregnant after the tubes have been tied…
Tubal Ligation Failure: Pregnant After A Tubal Ligation
Tubal ligation procedures are very effective at preventing pregnancy; however, no tubal ligation is 100% effective. Tubal ligation failures do occur, and pregnancies can happen naturally even after a tubal ligation procedure. Tubal ligation, regardless of whether the tubes are cut, burned, clipped, banded, or tied, is about 99 percent effective, meaning that about 1 percent of women will conceive an unplanned pregnancy after tubal ligation. This failure occurs slightly more frequently in younger women. A recent study (the Collaborative Review of Sterilization, or CREST, study) looked at 10,000 women who had undergone tubal ligation and found 143 failures (a failure rate of 1.4 percent). It can be higher when a tubal is done at the time of a C-section. The U.S. Collaborative Review of Sterilization (CREST) found the failure rate for tubal ligation (all occlusion methods) to be 1.85% after 10 years.
Tubal ligation failure rates are related to the technique used to perform the procedure – techniques that cause least damage to the tubes (such as tubal clips and tubal rings) have the highest failure rates. There is less of a chance of pregnancy where maximum damage to the tubes has been done (electrocoagulation methods) or where a large portion of the tube has been excised (bilateral partial salpingectomy). Newer hysteroscopic methods of tubal ligation such as Essure and Adiana also have failures; however, these procedures are much newer and the long term failure rates are not well known at this time.
When a tubal ligation fails and pregnancy occurs then there is a very high chance the pregnancy will be an ectopic pregnancy (tubal pregnancy). Occasionally the pregnancies can be inside the uterus and normal, but a very large number of them will be tubal pregnancies and may require surgical intervention.
Conceiving After Tubal Ligation Through IVF
In vitro fertilization (IVF) is one way to become pregnant after your tubes have been tied. The IVF procedure involves administering hormones to cause over production of eggs. These eggs are then harvested from a woman’s body, mixed with her partner’s sperm, and then reinserted into the woman’s uterus. This process by-passes the blocked tubes.
IVF procedures cost an average of $10,000-$12,000 for each IVF cycle. Each IVF cycle has about 35% chance of success. The success of IVF decreases with age and for women over the age of 40 many IVF providers recommend the use of donor eggs from a younger woman. In this case, the baby is not the genetic offspring of the birth mother (the IVF patient).
Conception After Tubal Ligation Through Tubal Reversal
Tubal ligation reversal provides women with the best chance of conceiving after a tubal ligation. Many tubal ligation patients and many medical providers are poorly informed about the chances of pregnancy success after a tubal reversal. During tubal reversal surgery, the reversal specialists remove the tubal blockage and reconnect the fallopian tubes. This technique of tubal anastomosis allows natural conception to occur.
There are several ways to perform a tubal reversal operation: robotic tubal reversal, laparoscopic tubal reversal, abdominal incision with a hospital stay, and abdominal incision without a hospital stay. The method of the reversal determines the cost of the reversal surgery. At Chapel Hill Tubal Reversal Center, we perform the reversal as a one hour outpatient operation through a small abdominal incision.
The cost for tubal ligation reversal is currently $5,400 to $5,900 and pregnancy success averages 70%. The chances of pregnancy after tubal reversal at our facility based on patient age, method of tubal ligation, and tubal length can be seen in our Pregnancy Statistics section on our website.
Can I Get Pregnant After My Tubes Have Been Tied?
You can get pregnant after your tubes have been tied. The three ways listed above are the only ways pregnancies can happen after the fallopian tubes have been tied. If you have a tubal ligation failure, you may be extremely lucky and have a normal pregnancy, but the chances are far greater the pregnancy will not be normal and will not happen naturally unless the tubes are surgically corrected. Many women wanting to conceive after tubal ligation will have to choose between IVF or tubal reversal and decide which method is the best for them.
Submitted by Dr. Charles Monteith