Pregnancy After Tubal Ligation: Is It Even Possible? Here's What to Know

Curious about “getting your tubes tied”?

If you’re certain your family unit is complete (even if it’s a family of one) and you’re fed up with contraception, a permanent method might be right down your alley.

Tubal ligation, or female sterilization, is thought to be a reliable form of birth control—its only difference being that it is non-reversible.

And it’s a popular option, with around 220 million couples around the world deciding it’s the right choice for them.

So if it’s so permanent and reliable, why are we talking about pregnancy after tubal ligation?

Is that even possible?

Well, it’s not common, but it can happen.

Here’s what you should know about becoming pregnant after tubal ligation.

In this article: 📝

What is a tubal litigation?

Before we talk about pregnancy after tubal ligation, let’s do a quick recap of how the procedure works.

Normally, during ovulation, an egg is released from your ovary and then travels through the fallopian tubes.

If sperm is waiting in the fallopian tubes for the egg, and fertilization is successful, the egg moves down through the fallopian tubes and implants in the uterus.

If the egg is not fertilized, it is reabsorbed by the body, and your endometrial lining sheds as period blood.

How tubal ligation works to prevent pregnancy is by basically cutting or blocking the fallopian tubes.

Wait, does getting your tubes tied stop your period?

Nope. Unlike a hysterectomy, this type of sterilization for women does not stop ovulation or menstruation.

And as for menopause, this will come naturally in time.

You see, with tubal ligation, your ovaries still release an egg—it just can’t be fertilized because there’s a cut or blockage in the fallopian tube preventing the sperm from meeting it.

So instead of getting pregnant, the egg is reabsorbed by the body, and your period starts.

How a tubal ligation is done

Now on to the tubal ligation procedure.

The good news is that female sterilization is now a far more minor surgery with quick recovery time and low risk.

As for the approaches, there are currently four main tubal ligation procedures and varying instances when they can be done.

You can opt for tubal ligation in an outpatient setting, shortly after giving birth—either vaginally or via c-section—or, depending on the procedure, in your doctor’s office.

And it all happens in a short amount of time under general anesthesia, so you don’t feel or remember a thing.

As for your chances of getting pregnant after tubal ligation, this largely depends on the surgery method.

So, let’s go through each one:

1. Laparoscopic tubal ligation

This is the most common tubal ligation procedure because of its low impact.

Basically, gas is pumped into your abdomen (all the better to see your organs), and a small incision is made under your belly button to insert a tiny camera called a laparoscope.

Once the doctor finds your fallopian tubes, they’ll make a second small cut to insert the tools needed to seal your tubes shut or remove them altogether.

This can be done by applying a clip, a ring, or even using heat to scar the tubes.

All of these approaches are highly effective, and the tubal ligation recovery time is quite quick—which is great news if you’ve just had a baby.

As for the chances of pregnancy, the American College of Obstetricians and Gynecologists estimates that rates range from 18 to 37 out of 1,000 women within the first ten years.

2. Laparotomy

A far more invasive tubal ligation procedure than the sophisticated laparoscopic sterilization, a laparotomy is essentially an open surgery.

It involves bringing your fallopian tubes up through a two to five-inch incision in your abdomen and cutting a segment from each tube to prevent pregnancy.

Because of less-invasive options, laparotomy is largely considered an outdated option, but it is still used after a planned or unplanned c-section delivery.

3. Mini-laparotomy tubal ligation

Named for the smaller incision used, a mini-laparotomy is typically done within 24-48 hours of vaginal birth.

It’s a far less invasive approach than a laparotomy, namely because the fallopian tubes are more accessible.

And it’s also an easier option for doctors to perform over a laparoscopy, requiring less skill and sophisticated tools.

Much like a laparotomy, it involves lifting your fallopian tubes to the incision made below your navel and closing them off with thread.

The likelihood is low, but pregnancy after this type of procedure could happen should the surgery fail to close one or both of the fallopian tubes.

According to one study, in the cases of mini-laparotomy, the risk of pregnancy after tubal ligation was greater among women who underwent the procedure soon after childbirth.

4. Hysteroscopic tubal ligation

Another quick, low-impact surgery, this type of tubal ligation can be performed either under general anesthesia or even under local anesthesia in your doctor's office.

It involves inserting a hysteroscope through your vagina and cervix (to help your doctor see), followed by small devices called micro-inserts.

These are placed into the opening of each fallopian tube, and as you heal, scar tissue forms around them, blocking any sperm from entering.

As for its success rates, hysteroscopic tubal sterilization is associated with lower pregnancy rates and complication rates than other forms of tubal ligation.

Is Essure still being used?

Come across Essure in your tubal sterilization research?

This was essentially a small coil spring device permanently inserted into the fallopian tubes during hysteroscopic tubal ligation.

But as of 2018, Essure devices are no longer sold and distributed.

This is largely down to adverse reported side effects such as pelvic pain, vaginal bleeding, and chronic abdominal pain.

FDA’s report on problems with Essure makes for a pretty harrowing read with 69,249 recorded reports between 2002 and 2022.

And of those reported in 2022, 44% cited litigation.

One of the most frequent device problems? Implant failure or pregnancy.

If you’re considering the surgery, it’s worth discussing the specific technique your doctor routinely uses and the pros and cons of each.

Don’t worry, Essure is no longer available on the market, but knowing the ins and outs of each tubal ligation procedure is essential for putting your recovery plans into place.

What are the side effects of having your tubes tied?

Okay, so the tubal ligation surgery is pretty minor but what about the side effects?

While the procedure itself is pretty low-risk, some mild side effects are to be expected—it’s still a minor trauma for your body.

Some common tubal ligation side effects include:

• Abdominal cramping
• Gassiness or temporary bloating (from the gas)
• Sore throat (if you needed a breathing tube for anesthesia)
• Fatigue
• Discomfort at the incision sight

Can tubal ligation cause problems later in life?

The vast majority of women who undergo tubal ligation have no noticeable long-term issues.

But as we’ve seen with Essure, complications can happen.

And even if these are uncommon, it serves us better when we have full awareness.

Outside of potential risks from the abdominal surgery itself, some women have reported suffering from post-tubal ligation syndrome.

While the literature is light on the topic, it’s thought to be a result of blood circulation problems around the fallopian tubes and ovaries.

The symptoms are mild but can include pain during intercourse, difficulty menstruating, hot flashes, and other symptoms of menopause like depression and irritability.

Of course, we don’t need to tell you that if you experience any discomfort long after your tubal ligation procedure, seek medical advice.

Let’s not normalize chronic female bodily pain or discomfort.

Is a vasectomy safer than tubal ligation?

Both vasectomy and tubal ligation are permanent, effective, and popular methods of birth control with little risk of complications.

So, which is the safest option?

Well, in terms of surgery, vasectomy is the least invasive.

The procedure is typically performed under local anesthesia and is done by cutting or sealing the tubes that carry the sperm from the testicle to the penis.

And while, of course, not without discomfort and needed recovery time, it’s a far cry from the more, erm, complicated elements of tubal ligation.

Between general anesthesia and the abdominal incision, the recovery for women can be longer while the risks can be higher.

What are the chances of pregnancy after tubal ligation?

In some rare cases, the fallopian tubes can open up or grow back together on their own after tubal ligation, making pregnancy possible.

Generally, this is more likely in women who are younger when they have tubal ligation surgery or when surgical errors have been made.

So, how common is pregnancy after tubal ligation?

Globally, the figure is roughly one in 200 women getting pregnant after tubal ligation.

As we mentioned above, the American College of Obstetricians and Gynecologists reports that between 18 and 37 of 1000 women may get pregnant in the 10 years post-tubal ligation (that’s 2-4%).

In one US study that followed over 10,000 women, pregnancy was recorded in around 1.3% of participants—that's 143 pregnancies.

So, figures vary.

Whichever number you look at, it’s important to understand that pregnancy after tubal ligation is rare.

What happens if you get pregnant with your tubes tied?

So, can you get pregnant with your tubes tied? Yes.

Your uterus, cervix, and birth canal are not affected by the procedure, so it is possible to have a healthy pregnancy and give birth after having tubal ligation surgery.

As long as a fertilized egg makes it into your uterus, your pregnancy should proceed normally.

That being said, you may be more likely to experience an ectopic pregnancy—where the fertilized egg implants outside of the uterus, usually in a fallopian tube.

An ectopic pregnancy isn’t viable, and it can be dangerous if not treated early.

Since tubal ligation shouldn’t affect your menstrual cycle, it’s worth being aware of when your period is late.

And if you are experiencing early signs of pregnancy after tubal ligation (nausea, cravings, breast tenderness, etc.), call your doctor ASAP to make sure everything is going smoothly—and to rule out an ectopic pregnancy.

Is tubal ligation permanent?

Basically, yes.

So, if there’s any chance you might decide to have children in the future, tubal ligation is not for you.

If you have a change of heart, you could discuss tubal ligation reversal with your doctor as it could reopen or reconnect your fallopian tubes but it depends on the procedure you’ve had.

Any tubal ligation method that involves clips or ties has a higher chance of being reversed than in surgeries where most of the fallopian tube has been removed.

But remember, tubal ligation is regarded as permanent, so it might not always be reversed.

A 2017 study exploring improvements in laproscopic tubal reanastomosis, found that the overall pregnancy rate post-surgery was 55.5% with the average conception time falling within 9 months.

Outside of this, the most common means to get pregnant after tubal ligation is in vitro fertilization (IVF).

How many people regret tubal ligation?

According to the very same study mentioned above, about 3-8% of women reported tubal ligation regret—regardless of much careful consideration beforehand.

Another study found that out of 1,549 women, 12.5% of those who underwent sterilization between 21 and 30 years of age regretted their decision.

While only 6.7% of those over the age of 30 felt the same.

And while this study took into account the ethnic diversity of the group, at most, it can only indicate that the younger you are opting for tubal ligation, the higher the risk of regret.

But age should never be a barrier to making an informed decision on your health.

In reality, only a small minority of women express regret—and that’s okay.

None of us have the gift of foresight.

Sometimes it may just be a passing moment of grief for something that could have been, even if you still know you made the right choice.

Other times regret can be the outcome of a decision that had nothing to do with not wanting children and everything to do with circumstance or health (we see you too).

The best you can do is give yourself space to fully reflect on the decision, do your research, and take your time to do what feels right for you.

Your Peanut community is here to support you no matter what you choose. ❤️