Tubal Ligation: Can My Tubes Come “Untied”?

Tubal ligation is a safe and effective surgical procedure used to prevent pregnancy and reduce the risk of certain health conditions. Although successful in the majority of instances, failure can occur, leading to unplanned or unwanted pregnancies. It is important to understand what can cause a tubal ligation to “fail.”

What is tubal ligation?

Tubal ligation, or getting your tubes tied, is a form of permanent birth control that involves cutting, tying, or permanently blocking the fallopian tubes. This process prevents the egg from traveling between the ovary and the uterus. It also prevents sperm from traveling through the fallopian tubes to reach and fertilize the egg. Unlike a hysterectomy, a tubal ligation does not affect your menstrual cycle.

How common is tubal ligation?

Tubal ligation is one of the most common surgical sterilization procedures for women. Statistics provided by the National Library of Medicine indicate approximately 700,000 tubal ligations are performed each year in the United States. A tubal can be performed at any time, but it typically occurs in conjunction with another abdominal procedure, such as a c-section.

Tubal ligations are a safe and effective way to prevent pregnancy. However, it is not 100% effective in all cases. There are instances where women may get pregnant after having their tubes tied. Although rare, statistics suggest that one out of 100 women will get pregnant within one year of having their tubal ligation procedure.

Are there different types of tubal ligation?

There are several different tubal ligation procedures.

Fimbriectomy

This procedure involves cutting the portion of the fallopian tube closest to the ovary.

Bipolar coagulation

A type of tubal ligation that involves applying an electrical current to the fallopian tube to cauterize (burn) different sections of the tube. These sections are generally between two and three centimeters long.

Monopolar coagulation

Similar to bipolar coagulation, this procedure also uses electrical current. Current is used to cauterize or seal the tube together. It is also used to further damage other areas of the tube.

Irving procedure

The Irving procedure involves stitching two sections of the tube before removing the areas between the stitches. The ends of the tube are attached to the rear of the uterus and other connective tissues.

Tubal ring

During this procedure, the fallopian tubes are folded over, and a band is placed over the folded portion.

Tubal clips

Tubal clips are similar to rings, and the procedure is also similar, except a clip is used rather than a band.

Pomeroy tubal ligation

This procedure involves doubling or folding a portion of the tube before placing a suture in the doubled area. The ends are then cauterized with an electrical current.

What are the benefits of tubal ligation?

As with many medical procedures, surgical sterilization has pros and cons. The most notable benefit of tubal ligation is that it provides lifelong birth control. Tubal ligation is often referred to as a permanent form of pregnancy prevention, and unlike the pill or even shots, it is impossible to use it in the wrong way.

Tubal ligation is also safe and does not have an impact on your hormone levels. Both birth control and other, more intensive sterilization procedures like hysterectomies, affect your hormones. Tubal ligation does not rely on hormones like the pill or other monthly birth control methods. Also, because your ovaries remain in place, your body’s natural hormone production does not change. A tubal will not alter your periods, change your hormones or trigger menopause as a hysterectomy can.

Can my tubes come “untied”?

This is unlikely. After a woman has a tubal ligation, it is doubtful her tubes will spontaneously untie or reconnect, allowing pregnancy to occur as it may have before a sterilization procedure. While tubal ligation is effective, there remains a very slight risk of pregnancy after a tubal.

Ectopic pregnancy

An ectopic pregnancy occurs when a fertilized egg implants in the fallopian tubes rather than the uterus. Ectopic pregnancies can quickly evolve into dangerous and life-threatening medical emergencies. Women, who become pregnant after tubal ligation, are at a greater risk of ectopic pregnancy. Some studies show the risk of ectopic pregnancy after sterilization is about seven out of every 1,000 procedures. They are also more likely to occur in women under age 30.

Tubal ligation failure

The chances of getting pregnant after a tubal ligation due to failure of the procedure are also relatively low, but pregnancy does occur in some instances. A study of 10,000 women showed 143 sterilization failures during the study. While this equals only about 1.5%, it is still notable for a procedure generally considered permanent birth control.

The possibility of tubal ligation failure varies based on the type of procedure performed. Clip sterilization is closer to 3.5%, while unipolar coagulation is less than 1%.

Can you get pregnant after a tubal ligation?

Some women may wonder if a tubal ligation is reversible or if there is a way to have children after tubal sterilization. There are options, however, it is crucial to remember that tubal ligation is meant to be permanent, and a reversal is not a simple or guaranteed procedure. It also involves undergoing a second surgery. The ease and effectiveness of a tubal reversal will depend on the technique used during your initial tubal ligation and other factors unique to your overall health. Some studies suggest success rates of up to 75% for pregnancy and 53% for carrying a pregnancy to term after tubal reversal.

Tubal ligation surgery is a common, highly effective permanent birth control option chosen by thousands of women annually. If performed correctly, failure rates are low, and you can rely on tubal ligation to protect you from unwanted pregnancy throughout your lifetime. Although procedural failure can occur in rare cases, it is not generally attributed to one’s tubes coming “untied.”