Pregnancy After Tubal Ligation: What You Need to Know

Tubal ligation involves blocking, cutting, tying, or sealing your fallopian tubes, preventing eggs from traveling to your uterus. This, in turn, prevents fertilization and pregnancy.

This contraceptive method is highly effective, but not 100% foolproof. 1 Read on for a look at how tubal ligation works and what the chances of getting pregnant are after getting your tubes tied.

During a tubal ligation, the fallopian tubes are either cut, tied, clamped, banded, or sealed using heat or clips. 2 This blockage stops your eggs from traveling from the ovaries to the uterus (where they would typically meet sperm for fertilization).

Some women opt for a salpingectomy, which involves removing the fallopian tubes entirely, further reducing the risk of pregnancy and lowering the risk of ovarian cancer. 3

The short answer is yes, you can get pregnant after undergoing tubal ligation, but it is rare. While the procedure should be a permanent form of contraception, it’s possible for your fallopian tubes to reconnect or develop a small passageway, allowing sperm to reach an egg. 4 This process is known as “recanalization,” where the tubes essentially regenerate and grow back together.

The likelihood of pregnancy after tubal ligation varies depending on factors such as age and the method used. In general, the failure rate is less than 1%. 5

Are there clear signs of recanalization?

Unfortunately, it isn’t possible to tell if your tubes have grown back together. Recanalization is a slow and gradual process, and it isn’t painful. Again, this very rarely happens, but the hard truth is that if it does, you might not know.

Other reasons implantation can occur after tubal ligation

Implantation (the process in which a fertilized egg attaches to the uterine lining) after tubal litigation can also happen due to:

• Surgical error: While it’s also uncommon, improper sealing or incomplete blockage of the tubes can leave an opening for fertilization. 4
• Pre-existing pregnancy: If you were already pregnant at the time of the procedure, getting your tubes tied won’t induce an abortion or otherwise terminate the pregnancy. Implantation of an already-fertilized egg can still occur after tubal ligation. 5

Which factors influence your pregnancy risk after tubal ligation?

Several factors may influence the chances of getting pregnant after tubal ligation:

• Age: Younger women have a higher chance of becoming pregnant after this procedure. 6 It’s worth noting that this doesn’t necessarily mean they’re more likely to experience recanalization; it could simply be due to being more fertile in general and experiencing higher pregnancy rates across the board.
• Method of tubal ligation: Some methods, like clips and bands, have a slightly higher failure rate than cutting and sealing. 7
• Time since procedure: Your risk of recanalization decreases over time. However, cases of pregnancies have been reported as much as 20 years after the procedure, so there’s really no way to be certain it won’t happen. 7

If you conceive after tubal ligation, you’ll be at higher risk of an ectopic pregnancy, where a fertilized egg implants outside your uterus, usually in a fallopian tube. Ectopic pregnancies are not viable and can be dangerous (even life-threatening). 8

Signs of an ectopic pregnancy

• Sharp or dull pain on one side of the lower abdomen
• Pelvic pressure or discomfort
• Light spotting or unusual vaginal bleeding
• Shoulder pain, which could be a sign of internal bleeding—a medical emergency
• Low back pain
• Dizziness or fainting

Call your doctor immediately if you suspect you have an ectopic pregnancy. Again, if a fertilized egg in your fallopian tube grows to the point where the tube ruptures, it can cause internal bleeding and shock. 8

Because tubal ligation is intended to be permanent, you should only opt for it if you’re sure it’s the right move. Some women regret getting their tubes tied, and, although it’s possible to reverse it (by artificially inducing recanalization), that isn’t easy and doesn’t always work.

Before you decide, consider:

• Your age and life status
• Your current relationship with your partner (if you have one)
• The alternative birth control methods available to you
• How certain you are that you’ll never want to conceive in the future

Before making a final decision, discuss the procedure with your doctor to ensure that tubal ligation is the right choice for you and your long-term reproductive goals.

If you think you might be pregnant after undergoing tubal ligation, call your doctor immediately. The risk of ectopic pregnancy complications makes early detection very important.

Your doctor can confirm whether or not you’re pregnant, as well as whether your pregnancy is developing normally in the uterus.

What are the signs of pregnancy after tubal ligation?

If you’ve had a tubal ligation but conceive anyway, your pregnancy symptoms will still be “normal” (i.e., what most pregnant women have). You may experience: 9

• A missed period (tubal ligation doesn’t stop menstruation)
• Breast tenderness
• Nausea and vomiting
• Fatigue
• Frequent urination
• Food cravings or aversions

If you experience any of these symptoms, you can take an at-home pregnancy test, but a blood test from your doctor will be more reliable. 10

What if you want to get pregnant after tubal ligation?

If you change your mind about having children after having a tubal ligation, talk to your doctor. There are two primary options to consider:

• Tubal ligation reversal: Depending on the method originally used, a surgical procedure can reconnect your fallopian tubes. Success rates vary, and pregnancy rates range from 50%–80% after reversal. 2
• In vitro fertilization (IVF): This assisted reproductive technology bypasses the fallopian tubes entirely. 11 Your eggs will be retrieved, fertilized outside the body, and implanted directly into the uterus. IVF has a success rate of 30%–50% per cycle, depending on age and other factors like sperm vitality. 12

Although tubal ligation is highly effective, it’s not 100% guaranteed to work. Contraception failure is rare but possible, and if you do get pregnant, you’ll face a higher risk of an ectopic pregnancy.

If you think your tubal ligation has reversed itself and you may be pregnant, call your doctor immediately. You may need prompt medical attention, but as long as you get it, you’ll be fine.