Occasionally, there are reasons why someone would want to get pregnant after getting this procedure. Perhaps you met a new partner with whom you want to have children, suffered the loss of a child, or simply changed your mind. Below, we speak to experts on whether this procedure can be reversed and if it’s possible to get pregnant again after getting your tubes tied.
What Is Tubal Ligation?
Tubal ligation is a form of sterilization and is, most often than not, permanent contraception. “A tubal ligation is a surgical sterilization procedure in which the fallopian tubes are either removed or disrupted (cut, clipped, or cauterized/burned). [This means] the released egg from the ovary cannot be reached by the sperm traveling up the tube, thereby preventing fertilization and pregnancy from occurring,” says Felice Gersh, MD, OB/GYN, the founder/director of the Integrative Medical Group of Irvine in California, and the author of “Menopause: 50 Things You Need to Know.” There are various approaches, ranging from minimally invasive to major surgery. “It can be performed laparoscopically (minimally invasive), with a mini-laparotomy (a small incision in the abdomen usually approximately 3 to 5 centimeters in length) or after delivery of a baby during a cesarean section,” says Hiamine Maass, MD, an OB/GYN at VivaEve. “Tying—this is the common way a tubal ligation is performed postpartum—happens right after a baby is born,” says Dr. Gersh. “The tube is secured with a suture, creating a tied loop, which is then severed and the cut edges are cauterized. This is a quick and easy procedure after birth, performed by making a tiny incision under the umbilicus and then reaching in and fishing out the tubes. This is easily done at the time of a cesarean section as well.” Dr. Gersh says clipping is not widely used anymore, because there is a risk of significant pain in the patient. For many years, the most popular tubal litigation approach was burning laparoscopically. “The tubes are visualized, grasped with a bipolar grasping device, and cauterized (burned). The tubal segment that was cauterized would die and seal off the tube," explains Dr. Gersh. Fallopian tubes can also be removed, either partially or completely. This is typically done immediately following a cesarian section or at another point via an open procedure. Dr. Maass explains, “This is done by tying the middle portion of the tube into a loop, while using absorbable sutures, then cutting a 2-centimeter portion of the loop segment." In recent years, many patients who wish to get their “tubes tied” have opted to get a full removal to lower their risk of ovarian cancer, called a salpingectomy. In fact, it’s recommended by many healthcare providers. “A complete tubal resection should be performed, if possible,” says Dr. Maass. “This is increasingly becoming the most popular option because the majority of ovarian cancers originate from the distal end of the fallopian tube. Studies have shown that removal of the tube [to prevent disease] is associated with an approximately 50% reduction in the risk of developing ovarian cancer,” adds Dr. Maass. The removal is a little more complex and time-consuming, but worth the effort. “It helps to lower the lifetime risk of developing ovarian cancer, which has a high mortality rate,” says Dr. Gersh.
Can You Reverse a Tubal Ligation?
It is unlikely a tubal ligation can be reversed, especially if your fallopian tubes were burned or removed. “Tubal ligation is considered an irreversible form of contraception,” says Lucky Sekhon, MD, double board-certified reproductive endocrinology and infertility specialist and OB/GYN at RMA of New York. “However, in certain instances, patients who have had a tubal ligation may change their mind and wish to reverse the procedure.” There are times when it may be possible; however, that doesn’t necessarily mean a pregnancy can come out of a reversed tubal ligation. “Reversal of tubal ligation is more likely to be successful after the use of clips which can be removed with minimized damage to the tissue,” says Dr. Sekhon. “Having the tubes fulgurated [destroyed] or burned will lead to the most damage and the most difficult time reversing the procedure.” “Some forms of tubal ligations can undergo reversal, with the most common technique being by tubal reanastomosis,” says Dr. Maass. “Tubal reanastomosis is performed by removing the portion of the tube that is abnormal, and reattaching the healthy remaining tubal segments with as little scarring as possible.” It doesn’t have a 100% success rate, and the success is impacted by the age of the patient and the time that passed between getting tubal ligation and the reversal. “Studies have shown that younger women (under 37) with at least 4 centimeters of healthy tubal tissue left tend to be the best candidates for reversal,” says Dr. Maass. “Patients who underwent silicone band placement and clip placement are more likely to have a successful reversal than those who underwent electrosurgical procedures or partial salpingectomies.” If you are a candidate for a reversal, there is some downtime associated with this procedure. “It may take a few months to fully heal—up to three,” says Dr. Sekhon. “Healing may involve scar tissue formation which can lead to partial or full occlusion of the tube eventually.” If that happens, there is a risk of an ectopic pregnancy, where the egg gets stuck in the fallopian tube. “Tubal reversal surgery is rarely done these days, due to the poor success rate and the better outcomes achieved with IVF,” adds Dr. Gersh.
How Can I Conceive After Having My Tubes Tied?
Most likely, if you wish to get pregnant after having your tubes tied, your healthcare provider will not recommend a reversal. Instead, they will most likely point you down the path of in vitro fertilization. “The most efficient and effective way to conceive after a tubal ligation is to undergo IVF,” says Dr. Sekhon. “IVF involves stimulation of the ovaries to mature multiple eggs, which are then extracted through the vaginal wall. The eggs are then fertilized with sperm and turned into embryos which can be then placed via the vagina and cervix, at the top of the uterine cavity.” This procedure works because IVF does not involve the fallopian tubes. “IVF treatment is recommended over tubal reversal for women who are older than 37, have less than 4 centimeters of residual tube, or who did not have a silicone band or a clip sterilization,” says Dr. Maass. In fact, if you wish to try to get pregnant soon after getting your tubes tied, you won’t have to wait that long. “Usually healing from a salpingectomy takes four to six weeks,” says Dr. Maass. “Starting the IVF process will depend on your provider’s preference since there are many steps to this process—ovarian stimulation, egg retrieval, fertilization, and embryo transfer.” Ask your provider, but after one to two months, you should get the green light to start IVF. “IVF has a high success rate after a tubal ligation, in healthy, younger women,” says Dr. Gersh. “There is no reason to delay starting IVF after about a month of healing [from getting your tubes tied]."
A Word From Verywell
It is possible to get pregnant after a tubal ligation, or getting your tubes tied. Sometimes the procedure can be reversed, but more often than not, your best chance of getting pregnant will be through IVF. Be sure to ask your healthcare professional if you have any questions about getting your tubes tied, or getting pregnant after the procedure.
