You may think you’re in the clear after undergoing tubal ligation. However, while over 99% effective, the procedure does not always prevent pregnancy.
If you’re finished having children, you may be considering tubal ligation. Also known as sterilization or “getting your tubes tied,” this common surgical procedure prevents pregnancy by blocking or cutting the fallopian tubes.
Many women choose tubal ligation over other birth control methods like condoms and the pill as the procedure is permanent. However, that doesn’t mean it’s 100% effective. About 1 out of 200 women who have their tubes tied will become pregnant, according to John Hopkins Medicine.
Tubal Ligation Failure
Tubal ligation failure can occur when the tubes grow back together. While the terms tubal (fallopian tube) and litigation (to tie) may indicate that the tubes are actually tied to prevent pregnancy, this isn’t the case. The tubes are not “tied,” but rather occluded or blocked through a surgical procedure.
When a woman undergoes tubal ligation, the tubes are cut and a small section is removed from each tube. This process blocks the pathway that the sperm would usually take to meet the egg.
Sutures are then placed around each of the cut ends to prevent bleeding. Over time, the sutures dissolve and the tubal ends naturally heal while leaving a small opening. While sperm can get through the opening, a fertilized egg cannot.
Tubal ligation failure occurs when the tube is not properly closed, allowing both sperm and a fertilized egg to pass through. While pregnancies can and do occur after tubal ligation, they are more likely to be ectopic or ‘tubal’ pregnancies in which the egg becomes implanted in the fallopian tubes instead of the uterus.
This can be dangerous to the mother and will usually require surgery. A fertilized egg cannot survive outside the uterus.
What the Experts Say
“Because both vasectomy and tubal ligation are nearly 100% effective, pregnancy rarely occurs. If it should, there is no effect on the fetus. If sperm were present in a woman’s fallopian tube prior to ligation, an ovum could be fertilized in the blocked tube, causing an ectopic pregnancy.”
Maternal and Child Health Nursing, Adele Pillitteri
“Pregnancy after having a tubal ligation can be serious because the risk of a tubal or ectopic pregnancy is much higher. If you are post tubal and believe that you may be pregnant you need to be pregnancy tested right away. If it is found that you are pregnant your physician will need to immediately determine where the pregnancy is. If the pregnancy is located in your fallopian tube a surgery will be required as the condition is life threatening.”
Tubal Ligation and Post Tubal Ligation Syndrome, Susan Bucher
“The pregnancy rate for all sterilizations is usually quoted as 3 to 7 per thousand (or 0.3 to 0.7 percent), which is very low but definitely not zero. More recent data suggest a significantly higher pregnancy rate when these patients are followed for up to 10 years.”
Sterilization Reversal, John L. Long
“Occasionally, tubal ligation fails, and the woman becomes pregnant. The pregnancy rate after tubal ligation is about 1 in 200, and is higher for younger women.”
Encyclopedia of Women’s Health, Sana Loue, Martha Sajatovic
“The term “tying tubes” is a common phrase, but should be avoided as it may incorrectly indicate to a woman that the fallopian tubes could later be easily untied, when in fact reversal of a tubal ligation is a complicated and costly procedure with a high failure rate. In the United States, sterilization is second only to oral contraceptives as the most frequently chosen method of contraception and is one of the most frequently performed surgeries.”
Varney’s Midwifery, Tekoa, L. King
Pregnancy After Surgery
Younger women are more likely to become pregnant after tubal ligation, according to the University of Pittsburgh Medical Center. Rates of pregnancy within 10 years after tubal ligation are:
- 5 percent for women under 28 years of age
- 2 percent for women between 28 and 33 years of age
- 1 percent for women 34 years of age or older
Some women may choose to undergo tubal ligation reversal in order to have another baby. During this costly procedure, a surgeon will remove any rings or clips that were used to block your tubes and reconnect the ends of the tubes to your uterus.
In total, the surgery takes about two to three hours. Pregnancy success rates after tubal ligation reversal ranges from 40 to 85 percent, according to WebMD.
Many things can get in the way of a successful pregnancy after tubal ligation. If you are considering tubal ligation reversal in order to become pregnant, or if you’re simply worried about falling pregnant after your surgery, talk to your doctor about your concerns.