Getting Pregnant After Tubal Ligation Reversal
SurgeryA. Christopher Ibikunle MD FACSSome women who have had a tubal ligation experience change in their circumstances and inquire about getting pregnant after tubal ligation reversal. Fortunately, the advancements in surgical techniques and technology make it possible in many cases to reverse their tubal ligation. But what are the chances a naturally occurring pregnancy is possible after a tubal ligation reversal? Keep reading to find out!
Is It Easy To Get Pregnant After A Tubal Ligation Reversal
If both partners are healthy and do not have other fertility-related issues, becoming pregnant after a tubal ligation reversal should not be difficult. Statistics show that younger women have a higher rate of success in becoming pregnant with women under the age of 35 having a 70-85% rate of pregnancy success and women over 40 years of age having a 30-40% success rate.
Having A Child After Hysterectomy
If you want to have children but you need a hysterectomy for medical reasons, it is possible for you to start a family. While you might be able to use your own eggs, you cant carry the pregnancy yourself.
One option is to have your eggs harvested for future fertilization and surrogate implantation. Harvesting can be done before the surgery if your ovaries will be removed, or after surgery if your ovaries are to remain intact. While a surrogate will carry the child, it will be your biological child.
If egg harvesting is not possible or you do not wish to go that route, there are other options. A male partner may provide sperm for a surrogate pregnancy, either of a donor egg or the surrogates egg. A female partner may carry a pregnancy resulting from her egg being fertilized. You may also consider adopting a child as an alternative.
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What Happens During A Salpingectomy
There are two types of salpingectomy surgical methods:
- Laparoscopic salpingectomy. A minimally invasive surgery performed using a laparoscope, a thin instrument with a light and camera at the end. It’s inserted through the abdomen using a small incision. Your abdomen is then inflated with gas to allow the surgeon to see your uterus and fallopian tubes in detail. Finally, surgical tools are inserted through other small incisions in your abdomen to remove the fallopian tubes. After removing excess blood and fluid, your surgeon will close the incisions with stitches or medical glue.
- Open abdominal salpingectomy. One large incision is made across your abdomen . Your surgeon will be able to access your fallopian tubes through this incision. Once your surgeon removes the fallopian tubes, they stitch or staple the incision closed.
A laparoscopic approach is preferred because it’s less invasive with a shorter recovery time and lower risk of complications. But an open approach may be necessary depending on other factors.
First Option: In Vitro Fertilization
In vitro fertilization is a medical treatment that bypasses the fallopian tubes. You do not need fallopian tubes to have IVFall you need are your ovaries, your uterus, and your partners sperm.
In-vitro fertilization is a process. It is neither quick nor always successful.but it can work and it can provide you an alternative treatment to reversal surgery.
IVF involves seeing a doctor and receiving injections of hormonal medications. The doctor will show you how to self-administer the hormonal injections at home. These hormonal injections are given over several weeks. The hormonal medications cause the womans ovaries to produce many eggs .
Hormonal levels are monitored every several days and the ovaries and egg development are monitored with a vaginal ultrasound. When the maximal number of eggs have developed, the eggs are removed from the womans body with a needlethis is a needle aspiration procedure.
Once the eggs are removed, the male partner will provide a semen sample to fertilize the eggs. The eggs are fertilized outside the body in an incubator and after fertilization the eggs are inserted inside the womans uterus. Hopefully some of the eggs will implant and you will be pregnant.
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Who Is An Ideal Candidate For Tubal Reversal
Patients who benefit most from a tubal reversal are generally younger with no other fertility factors whose ligation was performed using a clip or a silastic band without the use of cautery, says Dr. Ditkoff. Cautery can cause thermal damage bilaterally at the site of the tubal ligation and could cause destruction to the tubes that lessens the prognosis for a successful tubal reversal.
A patient who wants a reversal should have a fallopian tube that is at least 6 cm. in length. A patient with a significantly ligated portion of her tube, leaving her with a shortened tube or a fallopian tube without a fimbriated end, is not a good candidate for a tubal reversal either.
A patients age and whether theyre interested in getting pregnant more than once are also important consideration. If the patient is open to getting pregnant in the future, is young and fertile, which improves their reasoning for having a tubal reversal. The older the patient, the less fertile that patient is and typically the more aggressive that treatment should be, the recommendation usually being IVF.
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 doesnt 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 or burned will lead to the most damage and the most difficult time reversing the procedure.
The bottom line? Tubal ligation may be reversed if the tubes were clipped, tied, or fulgurated. It cannot be reversed if the tubes were completely removed.
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 doesnt 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.
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Ivf: A Hope And Numbers Game
At the start of IVF treatment, you hope to have your ovaries develop a large number of eggs.
You hope you can harvest enough eggs to start an IVF cycle. You hope enough eggs fertilize and start growing. You hope to end up with enough healthy growing eggs that can be put in the uterus. You hope at least one eggperhaps two eggsbut not three, four, or five can attach.
You hope that those eggs that attach and start growing dont miscarry.
IVF costs approximately $14,000 for each treatment. The cost is mostly determined by how much hormonal medication is needed to get you through an IVF cycle with a good number of eggs produced. Some women do not need much hormone to stimulate their ovariesother women may need a huge amount. A few womens ovaries will not respond at all to the hormonal medications. The more hormonal medications you have to inject then the higher the cost will be for your IVF treatment.
Approximately and 1 out 3 women will become pregnant with each treatment. IVF is safe but the main risks are exposure to hormonal medication and having multiple gestation . The main advantage of IVF is it allows women to avoid tubal reversal surgery.
On average, approximately 1 out of every 3 IVF cycles attempted will result in pregnancyor to put it another way, your chance of IVF success is approximately 30% to 40% for each IVF cycle attempted.
The Bottom Line On Pregnancy After Tubal Sterilization
Tubal ligation is one of the most effective methods of permanent birth control. Especially if youre over the age of 34 and have the procedure done following childbirth, its doubtful that youll get pregnant again.
This form of birth control is also complicated to reverse. If you are young or have even the slightest question in your mind about getting pregnant in the future, choose another form of birth control. There are many options out there make sure you find the one thats right for you.
Do you have an experience or comment to share about sterilization? Share it with us in the comments below. Wed love to hear from you!
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Can You Be A Surrogate After Tubal Ligation
Yes! It could actually mean youre a great candidate for surrogacy you have proven fertility and are most likely done building your own family, both of which are important qualities for a gestational carrier. Plus and this is also a critical point its extremely unlikely youll become pregnant on your own before the embryo transfer. Because the egg will be from the intended mother or an egg donor, your ovaries and fallopian tubes will not be involved in the process at all.
As Dr. Channing Burks Chatmon, a Reproductive Endocrinologist with Fertility Centers of Illinois explains, professionals are available to help you through these and many other issues related to family building.
Usually Getting Pregnant Without Fallopian Tubes Requires A Medical Procedure
When a woman with all of her reproductive organs gets pregnant, it’s because an egg drops from her ovaries and is “sucked up,” by the fallopian tubes, Dr. Brooke Hodes-Wertz, assistant professor in the Department of Obstetrics and Gynecology at the NYU Langone Fertility Center, told INSIDER. Once inside, sperm meet the egg in the tubes and fertilize it into a zygote. From there, the zygote enters the uterus through the tubes and grows into an embryo.
If a woman doesn’t have fallopian tubes which usually happens because she had a complication that required the tubes be removed she typically needs in vitro fertilization to become pregnant, since the process can avoid the tubes altogether, according to Dr. Hodes-Wertz.
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Pregnancy After Tubal Reversal: How Long Before I Will Be Ready To Try To Conceive
for discharge instructions after Adiana, Essure and tubal reversal surgery.Unless your reversal is particularly difficult, you may try as soon as you like. We have patients who have successfully conceived in the same cycle as their tubal reversal surgery. We will tell you after your reversal if you need to wait before trying and you will be given detailed instructions before you go home.
Pregnant After Tubal Ligation: Tubal Reversal
Pregnancy after tubal ligation reversal is another option to become pregnant after a tubal ligation procedure. Tubal ligation reversal is a surgical procedure where the blockage caused by tubal ligation is removed and the tubes are rejoined. This allows for many natural chances at becoming pregnant. Tubal reversal can be done as an in-patient procedure or in an out-patient procedure . The reversal surgeries can be done through an abdominal incision, laparoscopically, or with robotic tubal reversal.
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Who Gets A Salpingectomy
Women who have certain health conditions associated with their fallopian tubes may get a salpingectomy. It’s also recommended for women with a high risk of developing breast cancer and ovarian cancer due to BRCA gene mutations. Removing your fallopian tubes can help prevent women from getting these types of cancers because the most severe forms of ovarian cancer often begin in the fallopian tubes.
Things To Consider Before Getting A Tubal Ligation
Make sure you no longer want to become pregnant. Some patients may regret getting sterilized in the future. Even though tubal ligations can be reversed, it is considered permanent sterilization. Our health care team will provide counseling about the pros, cons, and effective alternatives to ensure that youre making the best decision for you.
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Can I Get Pregnant After A Salpingectomy
It depends on what type of salpingectomy you had. If you have a unilateral salpingectomy , you’ll be able to get pregnant, assuming the other fallopian tube is still functioning. If both fallopian tubes are removed , you are unable to get pregnant naturally.
If you’ve had a salpingectomy, you can pursue an IVF pregnancy. IVF is a process that involves fertilizing your eggs in a lab, then transferring them into your uterus.
What Treatment Options Are There
If you are having trouble conceiving and suspect that scar tissue and adhesions may be playing a role, your doctor will investigate with ultrasound or a procedure called a hysterosalpingogram . This is a special x-ray, where contrast material is injected through a catheter in the cervix to the uterus as x-rays are taken. This way the doctor can see how the dye flows into the fallopian tubes and whether they are open or blocked. In some cases, the treatment may actually be another laparoscopic surgery. If you choose to undergo another laparoscopy, IVF may be your best course of treatment in this type of situation, as it bypasses the fallopian tubes entirely. After a course of ovarian stimulation with fertility medication, eggs are retrieved from the womans ovaries, then mixed with sperm in the lab, and the resulting embryos are then transferred directly into the uterus. IVF success rates for women under 40 with tubal scarring or other types of pelvic-factor infertility are usually excellent, as long as there are no other underlying or complicating infertility factors.
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Reasons For Getting A Tubal Ligation
Tubal ligation is mainly performed on a woman who is absolutely certain she does not want to have children in the future.
It also is performed for women who do not want more children and desire to lower the risk of tubal and ovarian cancer in the future, whether or not their family has a history of ovarian cancer. In those cases, the patient will have their whole tubes removed to lower their risk of developing ovarian and tubal cancer later on in life.
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What Are The Advantages Of Getting A Salpingectomy
Salpingectomy treats certain medical conditions and prevents ovarian cancers in women who are at higher risk. The main benefit of the procedure is to relieve symptoms caused by conditions of the fallopian tubes and lower your risk of developing cancer. A salpingectomy can also offer permanent contraception so you will never become pregnant.
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What Happens During The Procedure
Just before open abdominal surgery, youll be given general anesthesia. The surgeon will make an incision a few inches long on your lower abdomen. The fallopian tubes can be seen and removed from this incision. Then, the opening will be closed with stitches or staples.
Laparoscopic surgery is a less invasive procedure. It may be performed under general or local anesthesia.
A tiny incision will be made in your lower abdomen. A laparoscope is a long tool with a light and camera on the end. It will be inserted into the incision. Your abdomen will be inflated with gas. This allows your surgeon to get a clear view of your pelvic organs on a computer screen.
Then a few additional incisions will be made. Theyll be used to insert other tools to remove the fallopian tubes. These incisions will likely be less than half an inch long. Once the tubes are out, the small incisions will be closed.
One Tube No Tubes Even More Problems
Shannas remaining fallopian tube provided her and her husband, Gerard, a good chance of conceiving naturally. Some time after her tubal torsion experience, when Shanna had finished her residency, they tried again and Shanna was soon pregnant. But there was a problem.
I kind of knew from the beginning that something was wrong, and that I might have had an ectopic pregnancy, says Shanna.
In an ectopic pregnancy, rather than the embryo implanting in the uterus, it implants outside the uterus, most often in the fallopian tube, which is what had happened to Shannas embryo. An ectopic pregnancy cannot be carried to term and is a life-threatening situation to the mother, because the embryo grows and ruptures the fallopian tube.
How to recognize an ectopic pregnancy
My OB/GYN decided to treat me medically, with methotrexate, a medication to help my body process the ectopic pregnancy. My doctor cleared me to do whatever I wanted to do. A couple of weeks later, I was at my moms house, about to hop on a plane and go to Hawaii, Shanna says. But the ectopic ruptured, and I almost died.
Shanna went to the ER, again in great pain, with severe internal bleeding. The team performed emergency surgery to stop the bleeding and save her life.
Within a year after her ectopic pregnancy, she had finished one round of retrieving and freezing her eggs. A few months later, she and Gerard completed a frozen embryo cycle. Unfortunately, the cycle wasnt successful.
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Pros And Cons Of Ligation Vs Sterilization
Now, there are other advantages to having the entire tube removed if a woman is planning a tubal sterilization. Tubal ligations have a known failure rate, a pregnancy after the procedure of as much as 3 to 5 pregnancies per 100 women over 10 years who had their tubal sterilization at the time other than when the baby was delivered, with laparoscopy. Women who had their tubes completely removed have a much lower failure rate, almost zero. Women who have a tubal ligation also have an increased risk of ectopic pregnancy or tubal pregnancy if they do become pregnant compared to women who’ve had their tubes removed completely.
Now, we know that putting a little clip on the tube, burning the tube, or cutting a loop of tube is quite simple and takes a very short time. Anybody could do it. Removing the whole tube takes a little longer. Studies recently published looked at women who were randomized to removing the whole tube at the time of tubal sterilization or cutting a loop out at the time of Caesarian section an easy time to do it as the tube is right there to look at and operate on.
One study used an advanced technique to take out the tube completely and found that time was only about five minutes longer compared to the standard procedure of taking out just a part of the tube. Another study using older techniques suggested took about 10 to 15 minutes longer. There was not significantly more blood loss with taking the whole tube out compared to just part of the tube.
