Tuesday, April 19, 2011

Pregnancy After a Tubal Ligation – Is it Possible?

Of the 650,000 women consenting to a tubal ligation each year, very few imagine that someday in the future they may actually desire another pregnancy. However, surprising life circumstances bring many women to this question: “Is pregnancy after a tubal ligation possible?” The answer is YES. However, how to get there will largely depend on the individual circumstances of the woman.

Tubal Reversal

Typically the preferred method among patients for achieving a pregnancy after tubal ligation is through the use of a surgical procedure called a tubal reversal. Some insurances will cover a portion of the cost of the procedure and, if the surgery is successful, then natural conception is possible. Furthermore, once the surgery is complete there is no follow up care necessary. However, not all women are candidates for a tubal reversal.
Tubal ligation is a term used to describe several different types procedures of which result in the destruction of the fallopian tubes. These tubes are necessary for the egg to travel to the uterus, therefore disrupting their function is a way to prevent pregnancy. The different types of tubal ligation procedures include:
  • Partial Salpingecotmy, where the tubs are cut and the ends are sealed shut
  • Clips or rings, which block the blood flow and function of the tubes
  • Cauterization, a procedure which burns a small portion of the tubes to destroy them
What type of tubal ligation was performed is essential in determining whether or not a woman will be a candidate for a reversal. The surgeon will need to be supplied with all the records from the original ligation procedure to try and determine if there will be enough healthy tube to repair. Women who have had a total salphingecotmy or cauterization are rarely considered for a tubal reversal because of the damage sustained during the ligation. In addition, if the surgeon decides to go ahead with the procedure he or she may not actually know if they will be able to repair the tube until they are already in surgery. Therefore, many women wake up from surgery only to find out that their tubes were inoperable. Success rates for tubal reversal range between 20-70 percent depending on the data.

In Vitro Fertilization

In vitro fertilization, or IVF, is another option for women who have undergone a tubal ligation and desire to become pregnant. The IVF procedure allows women to conceive by implanting an embryo created by her own eggs and partner's sperm into her uterus for pregnancy. This procedure bypasses the need for intact fallopian tubes. The main disadvantage of this procedure is IVF cost. It is generally not covered by insurance companies and the out of pocket expenses can be more than $10,000. IVF also requires the use of fertility medications, a small procedure to extract the mature eggs from the ovaries, and many doctors appointments and tests. However, this method is highly successful, does not depend on the quality of the fallopian tubes, and does not require major surgery.

Age Consideration
Another thing to consider is the age of the woman who is considering a tubal reversal. If she is over the age of 40, or in some cases 35, the likelihood natural conception after a tubal reversal is decreased. Therefore these women may be encouraged to consider IVF, even if their tubes qualify for a reversal.

8 comments:

  1. Wow! I had no idea this was possible. I'm curious about the different types of tubal ligation - what are the reasons for choosing one over the other? What is the likelihood of getting pregnant after cauterization vs. a clip?

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  2. Great questions. Typically the type of tubal ligation that is done depends on the physicians choice. The Salpingecotmy and cauterization used to be preferred methods, however they are more tricky to reverse. Especially in the case of cauterization, they have found that the heat damage extends beyond the intended cauterization site all the way up the tubes. Many times this damage is irreversible. For this reason, many surgeons are now choosing clips/rings because they cause much less overall damage and leave the whole intact tube so there is much to work with in the case a reversal is desired. So, if there is any doubt in your mind that you may one day want to be pregnant after tubal ligation - you would want the clip or ring. However, there are no guarantees in either situation and all procedures should be considered permanent.

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  3. Yes, this is great ..
    Now in this modern world nothing is impossible ..
    Tubal Ligation Reversal is very safe now ..
    but remember the legacy of this operation depends on the doctor moves.so make sure that the doctor has experience in this field.

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  4. I'm a bit sad. After my child was born I felt very pressured to have my tubes tied. My husband was deployed at the time and only had my family members here telling me I couldn't have another child by myself and using the fact he was in the army and deployed all the time against me. I went ahead with the procedure and now, a year and 1 month later still cry at what I did to myself. The doctor cut out a piece and burned them shut. My husband and I can't afford IVF and now I know it's pretty much out of the question to do a reversal. I'm at least glad I read this before I went through the steps.

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  5. I have to children one boy and one girl I did the tubal libation after my csection and now I regret it so much :( sad to hear it will be difficult to reverse

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  6. I have had my tubes tide 6 years ago and long now to have just one more. I reminded myself that the method used on me was cauterization and know now it might be impossible, but I was reminded of Sarai and Elizabeth and remember that all things are possible. And if I never give birth again I believe that that choice is now up to God. and if he says you have had enough then I accept that too.

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    1. I had my tubal done 17 years ago, and I now really regret it. I wish I could have at least one more child. But I am near 40, single and poor. I definately can not afford the reversal, not too mention if it is possible. I definately did not want any more children with the man I was with at the time, so I know why I did what I did. I never imagined myself wanting any more children, but now I do. Your post was a real comfort to me. Thank you.

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  7. I mean, I have never been so entertained by anything in my life! Thanks for sharing such a nice post.

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