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.
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.
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.