Pregnancy After Tubal Ligation

Questioner: genna
Subject: what are my chances of having another child

Question:
when i had my tubes tied after having my second child i was only 24yrs and the doctor said that within five yrs their was a chance that my body will heal and the tube will go back the way they was is that true is it true for the body to heal its self and is their anything i could do to try and conceive again?

Answer:
Hello,

If the tubal ligation was successful, the tubes will not "grow" back or "heal itself". That is the purpose of a tubal ligation. It is a permanent sterilization method. Because of your age, I would not have done a tubal on you. You were much too young.

You have two options for getting pregnant: (1) tubal reversal surgery. This is a microscopic surgery whereby the tubes are repaired and sutured back together. If it is successful, then you would have the ability to become pregnant naturally and repeatedly. You will need to use contraception again to prevent pregnancy if you don't want more kids. In the best hands, the chances of pregnancy are up to 70% per year of trying. The down side is you won't know until after the procedure has been done and the risks are that the tubes will scar together, or you will get a pregnancy that lodges in the tubes (called an ectopic pregnancy), which is a surgical emergency. Also, whether or not it can be repaired is dependent on the method that was used in the tubal ligation to begin with. The more damage that was done to the tube, the less repairable it is.(2) In Vitro Fertilization. In this case, the ovaries are stimulated and the eggs are removed directly from the ovaries. Fertilization and embryo development then occurs outside of the body in a specialized laboratory. The tubes are bypassed with this procedure. In general, it has a much higher pregnancy rate per attempt. In under 35 years old, you would have a 60-70% chance of pregnancy with each attempt. Nowadays, most people will do IVF because of the higher chances of success.

Both cost approximately the same so most will go to IVF. Beware of doctors that do tubal reversals but don't do IVF in their centers. They usually will counsel to do the surgery but not counsel regarding the option of IVF. On the other hand, most IVF centers will do both, but beware of the ones that don't even mention the surgery.

Good Luck,

Edward J. Ramirez, M.D., FACOG