Can You Get Pregnant After a Tubal Ligation? Chances and Options
Can You Get Pregnant After a Tubal Ligation?
Yes, it is possible to get pregnant after a tubal ligation. Pregnancy can happen in three main ways:
- Spontaneously (rare, but possible)
- After tubal ligation reversal surgery
- With IVF (which bypasses the tubes entirely)
If you are having pregnancy symptoms after a tubal ligation, take a pregnancy test right away. A prior tubal ligation does not rule out ectopic pregnancy, even years later.
Probability of Getting Pregnant After a Tubal Ligation
Your chances depend on your age, the tubal ligation method used, and whether you pursue reversal or IVF. The table below provides an overview of these methods and their pregnancy chances.
| Path to pregnancy | What it means | Typical takeaway |
|---|---|---|
| Spontaneous pregnancy | Pregnancy occurs without reversal or IVF | Uncommon, but documented over long-term follow-up |
| Tubal ligation reversal | Surgery reconnects the tubes so sperm and egg can meet naturally | Often best for younger patients with favorable tubal anatomy who want more than one child |
| IVF | Eggs are retrieved and fertilized in a lab, then an embryo is transferred to the uterus | Works even if tubes were removed or cauterized, and can be faster for time-sensitive cases |
Spontaneous Pregnancy After Tubal Ligation: What Are the Chances?
Natural pregnancy after tubal ligation is rare, but it happens.
The best long-term data comes from the U.S. Collaborative Review of Sterilization (CREST), a large prospective cohort that followed 10,685 women for 8 to 14 years and identified 143 sterilization failures.
Pregnancy Risk After Tubal Ligation Depends on the Method
Another large-scale study reported different 10-year cumulative pregnancy probabilities depending on how the tubes were blocked.
| Tubal ligation method (examples) | 10-year cumulative probability of pregnancy (CREST) |
|---|---|
| Clip sterilization | 36.5 per 1,000 procedures |
| Unipolar coagulation | 7.5 per 1,000 procedures |
| Postpartum partial salpingectomy | 7.5 per 1,000 procedures |
Important safety note
If pregnancy occurs after tubal ligation, the risk of ectopic pregnancy is higher than in the general population. If you have a positive pregnancy test with pelvic pain, shoulder pain, dizziness, fainting, or heavy bleeding, seek urgent evaluation.
How to Get Pregnant After Having Tubes Tied
Most people who are trying to conceive after a tubal ligation choose one of two options:
Both can lead to a healthy pregnancy, but the best choice depends on your age, tubal anatomy, sperm factors, and how quickly you want to try.
Tubal Ligation Reversal: How It Works
A tubal ligation blocks the fallopian tubes so sperm and egg cannot meet. A tubal ligation reversal is a surgical procedure to reconnect the tubes so fertilization can occur naturally again.
In a tubal ligation reversal (tubal reanastomosis), the surgeon removes the blocked segment and reconnects the healthy ends.
Success depends heavily on the amount of healthy tube remaining, the integrity of the fimbriae (the delicate end of the tube), and whether the original ligation method caused significant damage (e.g., extensive cautery).
Tubal Reversal Success Rates
Success varies widely by age and surgical factors. Published studies and reviews commonly report pregnancy rates in the 40% to 80% range across different techniques and patient groups.
At CNY Fertility, Dr. Robert Kiltz advises: “As long as there is sufficient length of the fallopian tube to reconnect the ends and the tubes are functioning properly, we anticipate a 60 to 80% chance of patients conceiving naturally within two years of their reversals if under the age of 35.”
Ectopic Pregnancy Risk After Tubal Reversal
Ectopic pregnancy risk is increased after reversal, but the exact rate depends on technique and patient factors. Large reviews report ectopic pregnancy rates commonly in the single digits overall, with higher rates in some subgroups.
IVF After Tubal Ligation: How to Get Pregnant Without a Reversal
IVF bypasses the fallopian tubes completely. Eggs are retrieved from the ovaries and fertilized in the lab. There, embryos are cultured for several days, after which one or more is transferred to the uterus.
Because IVF does not require functioning fallopian tubes, it can be a strong option if:
- Tubes were cauterized extensively or removed
- You are older, and time to pregnancy matters
- There is male factor infertility
- You want the fastest path to pregnancy per attempt
IVF Success Rates After Tubal Ligation
IVF outcomes depend primarily on age, ovarian reserve, embryo quality, and whether you are using your own eggs or donor eggs.
For the most reliable national benchmarks, SART publishes outcome tables by age group.
Male Factor Infertility: A Key Deciding Factor
Even if you have been pregnant before, semen parameters can change over time.
Male factor infertility can be the sole cause in about 20% of couples and contributes in another 30%.
This is why a semen analysis is a smart first step before choosing reversal versus IVF.
If sperm counts or motility are significantly reduced, IVF (often with ICSI) is frequently favored because it avoids relying on sperm traveling through the reproductive tract to find an egg.
IVF vs Tubal Reversal: Which Is Better?
ASRM notes that IVF tends to have a higher per-cycle pregnancy rate, while tubal anastomosis can have a higher cumulative pregnancy rate over time for appropriately selected patients, especially if multiple natural attempts are possible.
Use the comparison below as a practical decision guide.
| Consideration | Tubal reversal may be a better fit | IVF may be a better fit |
|---|---|---|
| Age and urgency | Younger, more time to try naturally | Older or time-sensitive |
| Tubal ligation method | Clip or band methods often more favorable | Extensive cautery or tube removal |
| Male factor infertility | Normal semen analysis | Abnormal semen analysis or ICSI needed |
| Family size goals | Want more than one child naturally | Want one child, or want predictable timing |
| Risk tolerance | Accept higher ectopic monitoring needs | Prefer bypassing tubal-related risks |
| Time to pregnancy | Can take months to years | Often faster per attempt |
What the Treatment Process Looks Like
Tubal reversal timeline (typical)
- Surgery is commonly around 90 minutes
- Recovery varies, but many people resume light activity quickly
- Many clinicians advise waiting for healing before trying to conceive
IVF timeline (typical)
Often several weeks from start to retrieval and transfer, longer if using embryo freezing, genetic testing, or frozen transfer
Multiple monitoring appointments plus procedures (egg retrieval and embryo transfer)
Cost: Tubal Reversal vs IVF
Costs vary widely by region, clinic, and what is included.
Tubal reversal at CNY
At CNY, tubal ligation reversal starts at $4,995, including anesthesia, surgical services, and facility fees.
Patients who undergo reversal at CNY may be eligible for a discounted IVF cycle if the reversal is unsuccessful (discount details may vary by program and time).
Nationally, the cost of a tubal ligation reversal is around $8,500.
IVF at CNY
Comprehensive IVF packages start at $6,300 for standard medications. While nationally the average is around $23,000+
FAQ: Can You Get Pregnant After a Tubal Ligation?
Can you get pregnant after a tubal ligation?
Yes. Pregnancy can occur spontaneously (rarely), after tubal reversal, or through IVF. Long-term studies confirm that sterilization failures can occur and vary by method.
Is it possible to get pregnant after a tubal ligation without surgery?
Yes, but it is uncommon. If you suspect pregnancy, test promptly and seek evaluation due to ectopic risk.
Can you still become pregnant after a tubal ligation years later?
Yes. Risk persists for years and depends on method and age at sterilization.
Which is better: tubal reversal or IVF?
It depends. IVF often has a higher per-cycle pregnancy rate, while reversal can offer strong cumulative pregnancy chances over time for well-selected patients.
What should I do first if I want to get pregnant after tubal ligation?
A practical first step is a consultation plus basic workup (your ovarian reserve testing and your partner’s semen analysis) so you can choose the approach with the highest chance of success for your situation.
Scheduling a Tubal Reversal or IVF Consultation
“It’s been my experience that many women who want to get pregnant after tubal ligation are older, so time is of the essence. We’ll help evaluate all of the factors at play and determine the best solution for each individual so they can have the little bundle of joy they’ve been dreaming about,” Dr. Ditkoff shares.
If you have had a tubal ligation and want to explore your options, schedule a consultation with CNY Fertility to review your medical history, discuss reversal versus IVF, and help you understand your expected costs and timeline.
