Chances of Pregnancy After Tubal Ligation 2023: Signs & Complication

Tubal ligation^[1] is sometimes referred to as tubal sterilization or having tubes “tied.” This form of birth control is regarded as permanent; therefore, it implies a philosophical commitment to being finished with one’s family before “burning bridges. The female’s fallopian tubes are cut, blocked, or tied during the tubal ligation procedure to prevent pregnancy.

The actual outpatient surgical procedure can be done at any time through a laparoscopic (minimally invasive) procedure. It can also be done at the same time as a C-section, which adds no recovery time.

After female surgical sterilization, any egg released by the ovaries cannot pass and get through the obstructed fallopian tube. Also, any sperm is prevented from going up the fallopian tube to fertilize an egg.

However, there may be pregnancy after tubal ligation. Tubal ligation reversal requires major surgery, and in most cases, the success rate is low and could risk a tubal pregnancy. 

The data on pregnancies after your tubes are tied vary. For example, according to a study^[2]by a group of medical researchers from various institutions, the risk of getting pregnant was about 1.5%. This large study followed, for 8 to 10 years, more than 10,000 women who had undergone tubal ligation. Out of the total, 143 of the tubal ligations failed (resulting in pregnancy).

Other reports put the chances of getting pregnant slightly lower, with 1 out of 100 (i.e., 1%) of women getting pregnant after undergoing this sterilization surgery.

However, according to ACOG^[3] (American College of Obstetricians and Gynecologists), the chances of pregnancy after tubal ligation can range from 1.8% to 3.7% within the first 10 years after the surgery.

To compare, while the highest percentage of failed tubal ligation is around 3.7%, taking birth control pills has a failure rate of 9%. These figures show tubal ligation is more effective than most other birth control methods.

Factors That May Increase Chances of Tubal Ligation Failure And Pregnancy

Age

Age is an essential factor in getting pregnant after tubal ligation without tubal reversal. It is one of the main factors increasing your chances of tubal ligation failure. 

Some doctors indicate that a woman has a 1 in 200 probability of getting pregnant if she gets the surgery in her 20s. Women who undergo tubal ligation sterilization surgery in their 30’s stand a 1 in 300 probability of getting a “miracle” pregnancy after tubal ligation.

Type of Tubal Ligation

There are various types^[4] of tubal ligation surgeries. While some tie off each tube in two spots and then cut between them, others remove the fallopian tubes or their ends altogether. Others involve burning a portion of each fallopian tube. 

Clips can crimp the middle of each tube, or tight bands can be placed over a midportion as well. There are others involving inserting plugs into the tubes where they open into the uterus–avoiding surgery since the approach is via the vagina.

The odds of getting pregnant may depend on the type of female sterilization one undergoes. As such, you must consult your doctor so that they can explain the available tubal ligation surgeries and choose one that best fits you. 

Symptoms of Pregnancy After Tubal Ligation

For the majority of women who have tubal ligations, their menstrual cycles are not affected, although the risk of heavier periods is triple^[5] that of women who don’t have a tubal ligation. Regardless, a missed period or getting a positive pregnancy test warrants consulting a doctor immediately. This is because women with tubal ligation have a much higher chance of experiencing an ectopic pregnancy. 

Ectopic pregnancy after tubal ligation is a serious medical condition in which a fertilized egg doesn’t attach itself inside the uterus. The fertilized egg gets “hung up” in the tube due to scarring or incomplete ligation, where it implants. Since only the uterus is designed to expand with pregnancy, if untreated, ectopic pregnancies can be fatal.

Pregnancy may result from the re-establishment of the fallopian tube canal after a tubal ligation surgery. 

Women with ectopic pregnancies after a tubal ligation are at higher risk of complications, e.g., hemorrhage, since there can be a delay in diagnosis: they incorrectly assume it can’t be an ectopic pregnancy because they had a tubal ligation!

Because the risk of life-threatening ectopic pregnancy is so high, many doctors will recommend in vitro fertilization (IVF) to bypass this risk.

Signs and Symptoms of a Normal pregnancy

In the case of pregnancy after a tubal ligation, most women experience symptoms similar to those who never had the surgery. These may include the following:

• Increased food cravings
• Tenderness and swelling in breasts
• Sensitivity to certain smells, especially those associated with food
• Morning sickness
• Nausea and vomiting
• General body fatigue
• Frequent urination
• Mood changes

Immediately after you miss your period or suspect you might be pregnant, taking a home pregnancy test is recommended. If you start experiencing a combination of these symptoms early on, the home pregnancy test might not be a reliable tool, and thus you need to consult your doctor.

The doctor will carry out a blood pregnancy test or perform an ultrasound to determine whether or not you are expecting and, if so, determine whether it is a normal or an ectopic pregnancy that requires intervention.

Signs and Symptoms of an Ectopic Pregnancy

Apart from the symptoms associated with a normal pregnancy, some other signs of an ectopic pregnancy may include the following:

• Vaginal bleeding (the bleeding can be light but may take more time than the normal spotting experienced during pregnancy).
• Severe abdominal pain, sharp and usually on one side–left or right–due to pressure of a swollen tube.
• Pelvic pressure when making a bowel movement.
• Severe pelvic pain
• Severe abdominal pain from internal bleeding from a ruptured ectopic.
• Passing out or being extremely lightheaded from either the pain or from severe internal blood loss.
• Shoulder pain, from blood irritating the diaphragm.

If ever you experience the above symptoms, you must seek immediate medical attention. An ectopic pregnancy is a severe medical condition that can cause a rupture of your fallopian tube, further causing internal bleeding. If left untreated, it can lead to severe internal hemorrhage and death.

Complications and Risks of Tubal Ligation

Minimal Complications

The complications and risks of tubal ligation procedures are minimal. These may include

• Separation of the surgery wound
• Infection at the place where the incision was made
• Getting scar tissue

Serious Complications

Serious complications can also occur. These may include

• Infection deeper in the abdomen
• Losing too much blood, as there is bleeding in all surgeries, most of it controlled
• An allergic reaction due to the anesthesia
• Injury to other organs during the procedure, especially when cautery (burning) is used in the procedure

Factors That May Increase the Risk of Complications

Several factors increase the likelihood of complications of a tubal ligation procedure. There are:

• Smoking
• Having high blood pressure
• Being overweight
• Previous abdominal surgery
• Lung disease
• Diabetes
• Issues with the heart

In short, any factor that increases the risk of complications for any surgery.

The Bottom Line

Soon after tubal ligation, if you notice any infection in the incision area or any swelling, discharge, or redness, you should seek immediate medical assistance. Additionally, if you are experiencing pregnancy signs after tubal ligation^[6], you need to see a doctor to be sure that your pregnancy is normal and not ectopic. 

Either way, you and your doctor will discuss the next course of action depending on what you want to do. This might save your life, especially in cases where the pregnancy is ectopic. However, in some states where abortion is illegal, treating ectopic pregnancy surgically may be considered abortion.

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