Is it possible? Pregnant After Tubal or Vasectomy

Pregnant Despite Tubal or Vasectomy

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Can You Get Pregnant After Sterilisation?

  • Sterilisation (male and female) is generally considered one of the safest contraceptive methods. Nevertheless, pregnancies sometimes happen despite sterilisation.
  • The probability of this happening is extremely low. Only 1-3 in 1,000 women become pregnant every year after sterilisation.
  • Reasons for this are surgical mistakes or oversights. In rare cases, recanalisation may occur: In women, the uterus and fallopian tubes reunite; in men, the vas deferens grows back.

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Probability and Causes

Pregnancies can still occur after vasectomies or tubal ligations. Here is an overview of the probability and the possible reasons:

Vasectomy

Tubal Ligation

Chances of Pregnancy

Pearl Index: 0.1 - 0.15
(1-2 in 1,000 women
per year)

Pearl Index: 0.2 - 0.3
(2-3 in 1,000 women
per year)

Reasons / Causes

  • Surgical mistakes

  • Remaining sperm during the short interval following the surgery

  • Recanalisation: Vas deferens reconnects

  • Surgical mistakes

  • Ineffectual method

  • Recanalisation: Fallopian tubes reconnect to the uterus.

Pregnant After Vasectomy

The Pearl Index (measuring the safety of contraceptive methods) for vasectomies is approx. 0.1-0.15. This means that one to two women in 1,000 who rely on vasectomy for contraception will get pregnant.

Even after a vasectomy, which is supposed to result in male infertility, pregnancies can still occur.

Possible Reasons:

  • One potential reason may be that complications arose during surgery or there was an oversight.
  • Sperm, present in the seminal vesicle or the seminal duct at the time of the procedure, may still be in the semen. This sperm would be capable of fertilisation weeks, or even months, after the vasectomy. Therefore, it is common practice to have a semen analysis two months after the procedure to determine whether the sterilisation was successful. Meanwhile, backup birth control methods are used. If this is not taken into consideration, pregnancy may occur.
  • While rare, the severed vas deferens may regenerate in the first few months after the vasectomy and grow back to create a new connection. This is called recanalisation. For this reason, one or two follow-up visits are encouraged. Very rarely, recanalisation happens years after the procedure, enabling the man to procreate again. Therefore, in some cases, pregnancies may occur years after successful sterilisation by vasectomy.

Pregnant After Tubal Ligation

The Pearl Index is slightly higher for tubal ligations (0.2 - 0.3) than for vasectomies. This means two to three in 1,000 women become pregnant after having their fallopian tubes cauterised or severed (tubes tied).

Possible Reasons:

  • Complications are possible also in this procedure.
  • Additionally, the kind of surgical sterilisation method chosen can make a difference. Severing or cauterising the fallopian tubes is generally more reliable than clamping them.
  • While rare, the uterus and the ovaries may reconnect via new channels. This is called recanalisation. It occurs more frequently in younger than in older women.

Am I Pregnant Despite Sterilisation?

You may feel very confused at the moment: You or your partner have been sterilised, and the possibility of a pregnancy was therefore entirely out of the question... But now you are noticing pregnancy symptoms.

Start by taking a deep breath. Your overdue period doesn’t necessarily mean that you are pregnant. A woman's monthly cycle, which usually continues after tubal litigation, is very sensitive. Many external factors, such as stress, diet, long-distance travel, infections or medications, can cause a delay.

Unintended Pregnancy After Tubal or Vasectomy — Now What?

If you are pregnant despite sterilisation, this news may have pulled the carpet from under your feet... After all, sterilisation gives you a sense of finality, which makes this pregnancy completely unexpected. Your pregnancy may also have gone unnoticed for a while, especially since – unlike condoms – sterilisations don’t come with classic 'contraceptive failures.'

Pregnant After Tubal or Vasectomy
Pregnant After Tubal or Vasectomy

While thinking through your next steps, take one of our free quizzes. Our team of compassionate experts has created these resources to help you sort through your thoughts and gain clarity:

  • ⚖️ Taking our free Abortion Test may also help as you wade through the 'whys' and 'what ifs.'
  • 🧑🏽‍⚕️ (Suspecting a) pregnancy — How soon to see a doctor? — Test

Sterilisation Facts

Sterilisation is the world’s leading method of birth control. On average, 18.9% of the world’s population relies on female sterilisation, whereas 8.4% of sexually active adults name vasectomies as their method of birth control. Europe has much lower numbers than the rest of the world, at 3.8% for tubal ligations and 2.7% for vasectomies. (Source: O’Neill Institute, 2018)

The prevalence of tubal ligations increases with age:

Research in the United States shows that, 4.2% of women aged 20-29 — 21.6% of women aged 30-39 — 39.4% of women aged 40-49 undergo tubal ligations for birth control. (Source: CDC, 2019)

Vasectomies

  • Male sterilisations (vasectomies) involve the severing and possible shortening of the two sperm ducts (vas deferens) in the scrotum. This prevents sperm from entering the semen (ejaculate). The ends of the vas deferens are sealed by cauterisation, tying, chemical substances and/or titanium clips.
  • A vasectomy procedure is less complicated and faster than a tubal ligation, which involves significantly more surgical risks.
  • Hormones and sperm are still produced, by which erectile function is maintained. However, the sperm is absorbed within a man’s system. Therefore, when ejaculation occurs, the semen no longer contains sperm cells, but only the fluid of the seminal and prostate glands.
  • Risk Factors: Vasectomies can be hard on men emotionally. One to two percent of men experiences physical complications, such as testicular infections, bruising or inflammation. Chronic pain (post-vasectomy pain syndrome) is also a possible side effect.

Tubal Ligations

  • Sterilisation of women by tubal ligation is a surgical procedure involving clamping, severing or cauterising of both fallopian tubes. This prevents egg cells from entering the uterus and fusing with a male sperm cell. The procedure is performed by laparoscopy or laparotomy.
  • Compared to vasectomies, some surgical risks are higher.
  • After sterilisation, the ovaries continue to produce hormones and ova (egg cells). Therefore, ovulation still occurs, but the egg cells are now transported via the mucous membranes of the fallopian tubes into the abdominal cavity, where they are absorbed. The procedure can lead to a decreased blood supply to the ovaries, which in rare cases can impair their function, including their hormone production.
  • Risk Factors: Side effects include mood swings, insomnia, low libido and hot flashes. Other physical risks and complications of tubal ligations include bleeding, infections and damage to internal organs. Depression or anxiety are frequently noted as side effects of the procedure.

FAQs

  • The likelihood of becoming pregnant after sterilisation is very low.
    2-3 in 1,000 women become pregnant per year despite tubal ligations. (Pearl Index: 0.2 - 0.3).
    1-2 in 1,000 women become pregnant per year despite their partner’s vasectomy. (Pearl Index: 0.1- 0.15).

  • There are several reasons for a pregnancy, e.g., complications during the operation or an unnoticed mistake.
    Fertilisable sperm may also still be present in the vesicular gland or the vas deferens for some time after a vasectomy. In women, the tubal ligation method may play a role in the effectiveness.
    Recanalisation could also allow for conception to occur. This involves the uterus and ovary reuniting in women and the vas deferens growing back in men.

  • Male sterilisation (vasectomy) involves cutting the two vas deferens in the scrotum. Female sterilisation (tubal ligation or “getting your tubes tied") blocks the two fallopian tubes. Tubal ligations are associated with more surgical risks than vasectomies. Still, other risks, such as infection or emotional repercussions, are possible for both genders. The Pearl Index is slightly higher for tubal ligations than vasectomies: After female sterilisation, 2-3 in 1,000 women will still become pregnant annually, compared to 1-2 women after their partner’s vasectomy. In addition to possible surgical errors, the vas deferens may reconnect. It is also possible for the fallopian tubes to reconnect to the uterus. Additionally, the method of sterilisation can affect the outcome. After a vasectomy, fertilisable sperm may still be present for some time, making pregnancy possible despite sterilisation.

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Authors & Sources

Authors

Jeanette Onusseit,
Psychologist and Counsellor

Kerstin Dörbecker,
MA English

Reviewed for Medical Accuracy

Team of Medical Doctors

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