Can I Get Pregnant After Tubal Ligation?

Tubal ligation is a permanent method of contraception. While it is possible to disassemble it, it is cumbersome and not always successful. Thus, the chances of becoming pregnant after tubal ligation are greatly reduced.

In this method, the fallopian tubes are severed, “ligated,” or blocked. In this way, it prevents both the ovum and the semen from entering the fallopian tubes themselves, making fertilization impossible.

Tubal ligation is a method of sterilizing a woman. It is an effective and safe method of contraception, but one in a hundred women may become pregnant naturally even after ligation.

Ligation of fallopian tubes

In general, tubal ligation is done to prevent pregnancy permanently. However, it can be dismantled by surgery, but this is quite cumbersome and can become very expensive. Also, it doesn’t always work.

The possibility of a dissection operation depends on how the tubal ligation was done, how it improved, and when it was done. The less damage there is to the fallopian tubes, the greater the chance they will be rebuilt surgically.

Parts of the fallopian tubes near the ovaries must be intact and at least four centimeters long. If the method used by the surgeon was cauterization, or incineration (doctors call it the Essure method), disassembly is impossible.

The easiest disassembly is when the ligation is done with clips or loops. In all cases, however, physicians should weigh the benefits and potential disadvantages of the disassembly procedure. They should also discuss with patients other options, such as in vitro fertilization.

In vitro fertilization

When dissection is impossible or does not seem promising, a good option to become pregnant after tubal ligation is to resort to in vitro  fertilization. This is a common treatment, and success in pregnancy is possible in 50 to 70 percent of cases.

In vitro  fertilization does not require fallopian tubes. This method can be used to collect eggs from the ovaries, fertilize them, grow the embryo and implant it in the uterus.

In order for a woman to decide whether the best option to become pregnant is to derail the fallopian tubes (where possible) or in vitro fertilization, she needs to consider certain factors with her doctor, such as the following:

• Age:  A woman under the age of 35 is more likely to become pregnant naturally, but the probability is only 15%. If a woman is over 40, the probability is 5%, and in addition, the risk of miscarriage is 40%.

• Male Fertility:  It is important to make sure your partner is fertile. Otherwise, pregnancy would be impossible with the natural method.
• Future fertilization: If a woman wants to have only one child, she may want to consider an  in vitro  method. Demolition of fallopian tubes is only profitable if a woman wants to have more children.

Possibility of ectopic pregnancy

An ectopic pregnancy is when an egg fertilizes but attaches outside the uterus, most often to the fallopian tube. In these situations, the fertilized egg does not survive, and in addition, the woman is at risk for severe internal bleeding.

Studies show that a small percentage of women who have undergone tubal ligation become pregnant (approximately 1.5%). In this group, one-third of pregnancies are ectopic.

When the fallopian tubes are ligated, there is still a risk of an ectopic pregnancy. This is the case for 10-20% of women who have had this measure.

On the other hand, women must also consider the possibility of a heterotopic pregnancy. In this case, there is one fertilized egg inside the uterus and another outside the uterus at the same time. This is very rare, but the  chance of a heterotopic pregnancy is 0.5-1% higher with assisted reproductive technology such as  in vitro  fertilization.

When to see a doctor

Any strange symptoms after ligation or disassembly of the fallopian tubes should be reported to your doctor. Be especially careful if the wound area is swollen, red or leaking.

Pregnancy suspicions can be clarified with a home pregnancy test. However, your doctor may also perform additional tests to confirm your pregnancy. The symptoms of an ectopic pregnancy should be well known and a doctor should be consulted if they occur.

Decoupling of fallopian tubes: a summary

It is important to carefully evaluate what is the best option to become pregnant after tubal ligation. According to the available data, the probability of successful dissolution is at most 60-80% for women under the age of 35 who have been ligation at least two years previously and who meet the criteria.

In vitro fertilization, on the other hand, is as successful as 70% in healthy women under the age of 35. This is achieved after one year of treatment.

Therefore, a woman should take into account all the influencing factors with her doctor when choosing the best option in each case.