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Pregnant Again: Restoring Fertility after Tubal Ligation

Apr 28, 2011

For more information or to request a photo, contact:
Catherine Gianaro,, (773) 564-7285

Infertility affects approximately 15 percent of couples, and about 1.3 million women.

But some women intentionally want to be infertile—they are done having children and don’t want the hassle and side-effects of conventional contraceptives, so they elect to undergo tubal ligation sterilization, a surgical procedure that is 99.5 percent effective as birth control.

An estimated 700,000 to one million women get their “tubes tied” each year in the United States. It’s the most common contraceptive method worldwide among married women (33 percent).

 Even though tubal ligation is considered a permanent form of contraception, approximately 10 percent of women have a change of heart and want to become pregnant again.

“Many women think there’s no hope of conceiving following a tubal ligation procedure, but they actually have options,” said Carlos Rotman, M.D., F.A.C.O.G, F.A.C.S, chief of gynecology and medical director of Women’s Health at Weiss Memorial Hospital, and associate professor of obstetrics and gynecology at Rush Medical College.

Dr. Rotman suggests patients who want to get pregnant, explore these treatments:

  • Tubal reversal. For patients who have undergone tubal ligation sterilization but are otherwise healthy, this may be the best option. Known as tubal reanastomosis (or “untying the tubes”), tubal reversal is the microsurgical repair and reconnection of the fallopian tubes to restore normal reproductive anatomy. This is traditionally done through laparotomy (opening the abdominal cavity), but a select group of surgeons are able to perform it laparoscopically, using minimally invasive techniques. The success rates with laparoscopic or open surgery are comparable; however, laparoscopic tubal reversal results in faster recovery, better healing, less pain, fewer complications and no large scars compared to traditional open surgery.
  • In vitro fertilization (IVF). This alternative to tubal reversal avoids risks associated with surgery, but women must endure the medications needed to stimulate the development of multiple eggs (which are not without possible complications), the many trips by the patient and her husband to the doctor’s office, and the high costs often not covered by the patient’s insurance. For these and other reasons, IVF is recommended for patients who may not benefit from tubal reversal because of other fertility problems.

According to Dr. Rotman, “Today, women seeking to become pregnant after a tubal ligation definitely have choices, but they should do some research and consult with specialists who offer both medical and surgical alternatives to ensure they get the type of treatment that’s best for them.”

For more information on medical options following a tubal ligation sterilization or Women’s Health at Weiss Memorial Hospital,  call (773) 564-6025.