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Pregnancy after tubal ligation: is it possible?
June 8, 2021
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It is possible to have a pregnancy after tubal ligation. Sometimes it occurs naturally, as the procedure fails. At other times it is possible to do a reversal surgery.
Last update: June 08, 2021
Tubal ligation is a permanent method of contraception. Although a procedure can be performed to reverse it, it is complex and does not always have a guarantee of success. Therefore, the chance of pregnancy is much lower.
This method involves cutting, ligament, or blockage of the fallopian tubes. Therefore, it prevents both the ovum and the sperm from moving towards the tubes themselves, making fertilization unfeasible.
Tubal ligation is considered a female sterilization method. It is safe and effective in preventing conception, but one in 100 women can get pregnant naturally after the procedure.
Tubal ligation reversal
Generally speaking, tubal ligation is performed to prevent pregnancy permanently. However, there is a surgical procedure to reverse it, but it is quite complex and can also be very expensive. Also, it doesn't always work.
The reversal procedure is possible depending on the way the tubal ligation was carried out, how it healed and when it was performed. The less damage has been to the fallopian tubes, the greater the possibility of reconstructing them by surgery.
In addition, the areas of the fallopian tubes near the ovary must have been kept intact and that these have a minimum length of four centimeters. If the technique used was cauterization or a procedure called Essure, reversal is impossible.
The easiest procedure to reverse occurs when the tubal ligation was performed with clips or tubal rings.. In any case, in all cases, the benefits and possible harms of the reversal procedure should be evaluated with the doctor. Also, analyze other possibilities such as fertilization in vitro.
In vitro fertilization
When tubal ligation reversal is impossible or unpromising, a good alternative to get pregnant is to go to fertilization in vitro. This is a common treatment and there is a 50-70% chance of achieving pregnancy.
With fertilization in vitro no longer need for fallopian tubes. This procedure allows the ovules to be collected from the ovary, fertilization, culture of the embryo and its implantation in the uterus.
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For a woman to decide if the best option to achieve a pregnancy is the reversal of the tubal ligation, when possible, or fertilization in vitro, it is necessary to take into account some considerations such as the following:
Age. A woman under 35 years of age is more likely to become pregnant naturally, but this is 15%. If you are over 40, the probability is 5% and you also have a 40% risk of miscarriage.
Male fertility. It is important to make sure that the couple is fertile. Otherwise, a pregnancy would be impossible naturally.
Future contraception. If the woman only wants to have a child, she may need to think about fertilization in vitro. Only if you want to have more children is it worth doing a tubal ligation reversal.
Possibility of ectopic pregnancy
Ectopic pregnancy occurs when the egg is fertilized, but implants in a place other than the uterus. The most common is to do it in a fallopian tube. In these cases, the fertilized egg cannot survive and there is also a risk of severe internal bleeding.
It has been established that up to a small percentage of women with tubal ligation become pregnant (approximately 1.5%). Within this group, onabout a third of them an ectopic pregnancy occurs.
When there is a tubal ligation reversal, there is also the risk of an ectopic pregnancy. This covers between 10 and 20% of women who have had this procedure.
On the other hand, heterotopic pregnancy is one in which there is a fertilized egg in the uterus and another outside it, simultaneously. It is very rare, but it is known that has increased between 0.5 and 1% with the use of assisted reproductive technologies, like fertilization in vitro.
When to seek medical help?
Any abnormal sign after tubal ligation or a tubal reversal procedure should be reported to the doctor. Be especially vigilant for signs such as swelling, redness, or discharge at the point where the incision was made.
Suspicion of pregnancy can be resolved with a home test. However, the doctor has the possibility of carrying out additional tests to confirm the pregnancy. It is necessary to know very well the symptoms of ectopic pregnancy and seek medical help if they occur.
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Tubal ligation reversal: yes or no?
It is important to carefully evaluate the best option for achieving pregnancy after tubal ligation. According to the available data, the maximum reversal success rate is in the range of 60-80% in those under 35 years of age who have had the ligation within two years and meet the criteria.
Fertilization in vitro, for its part, 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, you have to take into account all the factors that come into play and decide which is the best option in each individual case.