After welcoming your little one to the family, you and your partner may feel that your family is complete. The two of you may then decide that you don't want any more children. Whether due to personal choice or medical reasons that made future pregnancies risky, together you decided that tubal ligation was the appropriate step.
However, as the years have passed, you and your partner may have reconsidered and decided to have children once more. In this case, you may be wondering whether assisted reproductive technology (ART), such as intrauterine insemination (IUI), could help conception after tubal ligation.
What is a tubal ligation?
Tubal ligation, also known as "getting your tubes tied," is a surgical procedure used as a permanent method of birth control for women. During the procedure, the fallopian tubes, which connect the ovaries to the womb, are either cauterised (sealed using heat), tied and cut, or secured with bands or clips.
The procedure effectively closes the fallopian tubes, preventing eggs from travelling from the ovaries to the womb and blocking sperm from reaching the egg, so fertilisation cannot occur. However, this procedure doesn't affect your menstrual cycle, as the ovaries still release hormones and eggs each month.
There are two types of tubal ligation that can be performed. The first is unilateral tubal ligation, where only one tube is blocked, usually due to medical conditions. The other method, known as bilateral tubal ligation, closes both tubes and is the most common procedure performed to prevent pregnancy.
Tubal ligation is considered a safe and permanent method of contraception. If you're sure you don't want to get pregnant, your fertility doctor may suggest it. The procedure can also be performed soon after childbirth or during a caesarean section, so there is no need for a separate surgical appointment.
Is it possible to get pregnant with IUI after tubal ligation?
No, IUI isn't an effective fertility treatment following tubal ligation. This is because IUI only helps to reduce the distance that sperm must travel to reach the egg in the fallopian tube. However, this treatment still relies on natural ovulation and fertilisation in the fallopian tubes for conception.
If both tubes are blocked, as in a bilateral tubal ligation, the sperm cannot reach the egg, and fertilisation cannot occur. However, if only one tube has been sealed (unilateral tubal ligation) and the other tube is healthy, pregnancy may still be possible, either naturally or with IUI.
If you're considering another pregnancy after having a tubal ligation or would like to find out more about your fertility options, schedule an appointment with Thomson Fertility Centre today.
What are the alternatives to IUI after tubal ligation?
Although IUI might not work due to the nature of this fertility treatment, this doesn't mean that you won't be able to conceive again. There are two primary ways to achieve pregnancy after tubal ligation, which are:
Tubal reversal surgery
Although tubal ligation is a type of permanent contraception, it can sometimes be reversed using a tubal reversal surgery. During the procedure, your fertility specialist will make small incisions in your abdomen and use microsurgical techniques to reopen and reconnect the closed sections of your fallopian tubes.
This process creates a natural passageway for eggs and sperm, enabling fertilisation to occur. However, this procedure does not always ensure pregnancy. The success of the procedure depends on a few factors:
Your age at the time of the procedure
The type of tubal ligation procedure that was performed
The amount of scar tissue from the tubal ligation procedure
The time that has elapsed since the ligation procedure
The number of healthy fallopian tube segments remaining for successful reconnection
If you are under 35 years old at the time of the procedure, the success rate ranges from 50% to 80%, but this declines with age. You are also more likely to become pregnant if your tubes are secured with bands or clips rather than being cauterised (sealed using heat).
However, please note that this procedure increases the risk of an ectopic pregnancy, where a fertilised egg is implanted in the fallopian tube rather than the womb. This is a medical emergency requiring the prompt attention of a healthcare provider.
In vitro fertilisation (IVF)
An alternative to tubal reversal surgery is IVF, where sperm and eggs are fertilised outside the body. This fertility treatment involves retrieving eggs from your ovaries and fertilising them with sperm in a laboratory. This treatment can increase your chances of becoming pregnant because your fallopian tubes are not needed for fertilisation.
Afterwards, a procedure is performed to transfer the fertilised egg (embryo) back into your womb, where it can develop further. A complete IVF cycle usually lasts four to six weeks but can take longer if necessary. Success rates are around 40–50% per cycle if you're under 35 years old but will decrease with age.
Below are some of the advantages of IVF over tubal reversal surgery:
Lower risk of complications such as ectopic pregnancy
Allows for genetic testing of embryos if deemed necessary
Require only minimal procedures to retrieve eggs directly from your ovaries
Fertilisation occurs in a lab, which can help to increase the chances of fertilisation.
The resulting embryo is transferred directly into your uterus to start the implantation process.
Our IUI and IVF specialists
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Which treatment option is right for you?
Before deciding on the right fertility treatment for you, your doctors will thoroughly assess your condition after your tubes are tied. They'll also consider other factors that might affect which treatment is right for you, such as:
Your age:
If you are under 35, you may benefit more from tubal reversal surgery, as the success rates are higher and there is a greater chance of natural conception.
If you are over 35, IVF may be a more effective option, as fertilisation occurs in a controlled laboratory environment, which carries a lower risk than reversal surgery.
Type of tubal ligation:
The method used in your original ligation procedure can impact your options. Some methods, like cauterisation, can do more harm to the fallopian tube than other procedures, such as ligation with bands or clips.
Overall fertility health:
If you or your partner have additional fertility issues, such as a low sperm count or irregular ovulation, IVF may be a better option, as it can address multiple factors simultaneously.
Timeframe considerations:
Your fertility specialist will also consider the timeframe for conception. IVF can provide faster results, with the potential for pregnancy within a few months.
In contrast, tubal reversal requires recovery time (several weeks), followed by 6 to 12 months of attempting natural conception.
Desire for multiple children:
Your doctor will also consider your long-term family plans. Tubal reversal allows for multiple natural pregnancies over time without the need for further procedures.
With IVF, however, each pregnancy attempt typically requires a new cycle, although frozen embryos from previous cycles can be used.
The most appropriate treatment method for you will depend on your specific medical needs. Your fertility specialist will help determine the most suitable fertility treatment to help you conceive after a tubal ligation procedure.
For further consultation on which procedure is most suitable for your fertility condition after tubal ligation, schedule an appointment with Thomson Fertility Centre. Our specialist can help provide you with detailed information about tubal reversal surgery and IVF, including their benefits, potential risks, and expected outcomes.
FAQ
What is the easiest way to get pregnant after a tubal ligation?
The most direct way to conceive after tubal ligation is through in vitro fertilisation (IVF). This is because IVF bypasses the fallopian tubes entirely by bringing eggs and sperm together in a laboratory and transferring the resulting embryo directly into your womb.
This method may be particularly suitable if you wish to achieve pregnancy quickly or if a tubal reversal is not possible or recommended in your case.
Can I get IUI with no fallopian tubes?
No, IUI cannot be performed without at least one open, healthy fallopian tube. This fertility treatment relies on sperm travelling to the fallopian tubes to fertilise the egg naturally. Without any tubes, this process cannot occur, making IUI ineffective.
How long can tubes grow back after tubal ligation?
The fallopian tubes do not naturally grow back after they have been cut, tied, or sealed during a tubal ligation procedure. However, in extremely rare cases, the tubes may reconnect or form a new passage, a process known as spontaneous recanalisation.
If this happens, it can make pregnancy possible, including ectopic pregnancy, but this is very uncommon.
Where does the egg go after tubal ligation?
Even after tubal ligation, your ovaries will continue to release eggs as part of your normal cycle. However, since the fallopian tubes are blocked or sealed, the egg cannot reach the womb and is instead harmlessly reabsorbed by your body, usually in the area near the ovary or within the blocked section of the tube.
Is gender selection possible in IUI?
No, IUI does not allow for gender selection. The procedure simply places prepared sperm closer to the egg to increase its chances of natural fertilisation. Gender is determined by the sperm that fertilises the egg, which happens naturally and cannot be controlled via IUI.
Can IUI be successful with one fallopian tube?
Yes, IUI can be successful if you have one healthy, open fallopian tube. Provided ovulation occurs on the same side as the functional tube, or the tube can capture the egg from the opposite ovary, natural fertilisation is still possible.
Success rates per cycle depend on factors such as age, ovulation patterns, the location of the blocked tube, and overall fertility health. However, if the open tube is damaged or if other fertility issues are present, your doctor may recommend alternative treatments, such as IVF, to increase your chances of conceiving.
The information provided is for general guidance only and should not be considered as medical advice. For a personalised fertility consultation and tailored advice, schedule an appointment with Thomson Fertility Centre today.