Your Options After Tubal Ligation

At Arizona Center for Reproductive Endocrinology & Infertility, tubal ligation is one of the most common reasons for referral of patients who are thinking of having another child.

There are several options for “permanent sterilization,” which many women and couples choose to use as birth control, but the most common is tubal ligation, also known as having your tubes tied. The procedure is usually done laparoscopically, which means it is minimally invasive, and can be done the day of the delivery or in the days following—depending on circumstances. With interval ligation, the procedure is completed some time—six months to a year or even beyond—after a woman has given birth.

 

Types of Tubal Ligation

When women have had a tubal ligation and they visit us wanting to have another child, one of the things we talk about is the type of technique that was used to tie their tubes. This factor determines the success of treatment and ultimately having a baby.

Non-cautery

With non-cautery tubal ligation, the doctor does not burn the fallopian tubes. Some popular methods of non-cautery procedures include Filshie clips and the Yoon ring; these are applied through a laparoscope and tend to not be as damaging to the fallopian tubes over time.

Tubal Cauterization

Tubal ligation through a cautery procedure is considered the traditional method for permanent sterilization. An instrument is used to cauterize (or burn) the fallopian tubes. This often damages and destroys much of the tubes, making it difficult to surgically put back together.

Essure Coils

Although, it’s not technically tubal ligation, using Essure coils as a form of permanent sterilization is becoming more common. The Essure coil is placed into the fallopian tubes through the cervix and uterus. Some patients have reported pain after the procedure. It’s a very reliable method of birth control, and it’s essentially the same as having your tubes tied, but it doesn’t leave an abdominal scar from the procedure. It’s possible to reverse the procedure, but the coil causes such damage to the fallopian tubes that it is difficult for a woman to get pregnant even after they’ve been removed.

 

Pregnancy After Tubal Ligation

“Treatment,” or helping a woman achieve pregnancy after a tubal ligation procedure, typically falls into two categories.

Tubal Reanastomosis

Tubal reanastomosis requires removing scar tissue or the clip/ring and putting the intact and undamaged parts of the fallopian tube back together using micro-surgery. Although this is a successful and common procedure, it can be expensive and also runs the risk of a woman having an atopic or tubal pregnancy.

In Vitro Fertilization

The other option for reversal is in vitro fertilization, which doesn’t require any type of surgery to put the tubes back together. It’s done in the usual process, by retrieving and fertilizing the egg in vitro, then placing the embryo into the uterus. Because IVF is so successful and much less expensive, it’s usually a more cost-effective option than tubal reversal surgery.

When we treat a woman through tubal reanastomosis, she can theoretically go on to have as many babies as she wants. Most women who opt for tubal ligation have already had children, and want it reversed in order for them to have a baby with their new partner. IVF is usually the better option in this case, because after the woman gets pregnant, her birth control method is still in place since her tubes are still tied.

Many patients end up choosing IVF as their treatment because it’s easier, less expensive, less invasive, and delivers quicker results. With IVF, there is a high likelihood that a woman can get pregnant the same month she begins treatment. Tubal reanastomosis, on the other hand, requires several months of recuperation, plus the time it takes to achieve a natural pregnancy. It’s also not guaranteed that a woman is able to have a successful pregnancy after the surgery; there’s a chance she will have an atopic or tubal pregnancy, which results in complications, and will then need to have IVF in order to have a baby.

 

One thing we want our patients to understand is that it’s relatively easy to have another child after their tubes have been tied; it’s just a matter of how we go about doing that. Treatments and procedures are always your choice. Regardless of the treatment you decide to proceed with, our team at AZCREI will walk with you through the process, answer your questions, and be there for you every step of the way. To schedule a consultation, contact us online or call (520) 326-0001.