– Tubal ligation is a permanent birth control method that can be reversible.
– Tubal recanalization is successful in young women without other infertility factors.
– In Vitro Fertilization is another option for achieving pregnancy in older women or those with other altered fertility factors.
Tubal ligation or tubectomy is a family planning method that consists of blocking or sealing the Fallopian tubes to prevent sperm from traveling from the vagina to the ovaries. This blockage is achieved by tying, cutting, or cauterizing a section of the tube.
Tubectomy can be performed during a cesarean section, through an incision in the navel using a telescope to access the abdomen (laparoscopy), or through a two-centimeter incision in the lower abdomen (minilaparotomy).
It is considered a definitive or irreversible birth control method because a portion of the tube is destroyed. Some women, due to changes in their life circumstances, may change their minds and wish to become pregnant again after undergoing this procedure. There are two options to achieve pregnancy after a tubectomy:
– One of the options is to reverse the ligation by reconnecting the tube (recanalization). This is an outpatient surgery, complex but not dangerous. It can be highly successful in young women and when there are no other infertility factors. However, pregnancy may take up to a year to occur. Factors that negatively affect the chances of success include the woman’s age (especially over 38), problems with the man’s sperm, the presence of endometriosis or pelvic adhesions, or when the destruction of the tube has been extensive. A later risk associated with this recanalization is that, after fertilization occurs in the tube, the embryo may fail to reach the uterus and begin to grow within the tube itself. This is called an ectopic pregnancy; for this reason, it is very important to perform an ultrasound as soon as pregnancy is achieved to confirm the correct placement of the embryo in the uterus.
– The other option is In Vitro Fertilization (IVF), which involves extracting the eggs from the ovary and taking them to the laboratory. There, under controlled temperature and humidity conditions, they are brought into contact with the partner’s sperm to allow fertilization to occur. The fertilized eggs are then kept in an incubator for three to five days until the first cell divisions take place. Once the embryo has developed into several cells, it is transferred into the uterus through the vagina, where it continues to grow. This process avoids the need for sperm and eggs to travel through the Fallopian tubes and helps overcome problems such as very low sperm count or motility, or the presence of pelvic adhesions. Pregnancy can be achieved more quickly, making this method ideal for women over the age of 38 who cannot wait one or two years for a spontaneous pregnancy to occur.
