IVF After Tubal Ligation
Home / fertility treatment / IVF After Tubal Ligation

IVF After Tubal Ligation

The fallopian tubes or oviducts are the connection between the ovaries and the uterus. They are the channel through which the egg or oocyte travels to get to the uterus after being ovulated from the ovaries. They are also where fertilization (ampulla) occurs before the embryo gets implanted in the uterus. Ligation or the closing of this tube will prevent all these processes from occurring, which then prevents natural conception and pregnancy.

What is tubal ligation?

What is tubal ligation?
Picture courtesy: Cleveland Clinic

This can also be referred to as bilateral tubal ligation; the main aim of this procedure is to prevent sperm cells from reaching the oocyte which then prevents fertilization and pregnancy. The surgical procedure cuts or removes some parts of the fallopian tube. This surgery is considered safe, permanent, and largely irreversible. This method of contraception is usually advised for women who have completed their reproductive cycle or those that are sure that they do not have any intentions of giving birth to children.

Is there any way to reverse tubal ligation?

Unfortunately, some women discover that they have decided to undergo this procedure too soon. This is because, over the years circumstances arise, that may arise which make them want to eventually have children. Tubal ligation reversal is an option in this case; this is where the cut tubes are joined together. This procedure is quite difficult, and in some cases, does not work because the tube has lost function. The success of the procedure also depends on the amount of tubal tissue that has been removed, the time difference between the ligation surgery and the reversal surgery, and the age of the patient. Some of the factors which may inhibit fertility after tubal reversal surgery include:

  • State of the tubes – this comes into play when the stumps of the ligated tubes are too scarred or too short to reconnect. This usually means that the ligation cannot be reversed and that the woman cannot conceive naturally anymore.
  • Male fertility – this can be a factor causing infertility after tubal ligation reversal. If the male sperms are not good enough to achieve natural fertilization, then IVF is the best way to achieve this fertility.

Why is IVF preferred over tubal ligation reversal surgery?

The most reliable method of achieving pregnancy after tubal ligation is through IVF. The benefits of IVF over tubal ligation reversal include:

  • There is a reduced risk of the pregnancy being ectopic – this happens when the embryo implants in the oviduct or fallopian tubes instead of the uterus. It is one of the risks women that undergo tubal reversal surgery face when they try to conceive.
  • IVF prevents the necessity of an invasive surgery – to reverse a ligation, an invasive surgery must be done. The two ends of the tubes must be re-attached through surgery before any conception or pregnancy can have any chance of happening. IVF prevents the need for that invasive surgery.
  • There is a higher chance of pregnancy – IVF provides the best chance for women that have had children before and are still within childbearing age, more so than tubal reversal surgery.
  • There is a chance for pregnancy to occur in a shorter time – after tubal reversal surgery, the patients have an extended recovery period, after which they undergo tests that will ascertain that the surgery was successful, all before any conception will take place. This cannot be compared with IVF which only takes about two months.
IVF and tubal ligation
Picture courtesy: Eugin Clinic

What is the IVF process?

In vitro fertilization is one of the common assisted reproductive techniques chosen by women that want to get pregnant following a period of a failed effort to conceive. The steps before the process involve the evaluation of fertility. The consultation also includes a discussion of the medical history of the individual. Ovarian reserve testing is also done, which informs the doctor if the patient is a good candidate for IVF. The entire IVF procedure may be classified into steps, they include:

Fertility medication

This step involves the administration of medication that stimulates the ovary to mature multiple follicles for ovulation, in other words, fertility medication. Most women take this medication for about 8-14 days. This medication aims to ensure that there are multiple eggs to be harvested during egg retrieval. Averages of 10-20 eggs are retrieved for IVF, though not all the retrieved eggs are viable. A protocol to harvest a maximum number of eggs while avoiding ovarian hyper-stimulation syndrome is designed.

Egg retrieval 

The follicles are usually monitored via ultrasound to determine when they are ready to be retrieved. When the follicles are ready, a trigger shot of hCG will induce the eggs to mature. This shot replaces the naturally occurring luteinizing hormone surge that a woman has which spurs the final stage of egg maturation. The egg retrieval procedure occurs about a day and a half after the trigger shot. This is timed before ovulation occurs; an ultrasound is used to visually guide a small needle to the ovaries.

The procedure is done under anesthesia so there is minimal pain and discomfort. The follicles are pierced with the needle, and a gentle suction aspirates the follicular fluid which carries the egg along. The entire process does not take time, usually less than an hour. The follicular fluid and egg are suctioned into a test tube which is then handed to an embryologist. The embryologist identifies the egg in each test tube, then records all the details of the egg.


The eggs are transferred to a lab where they are tested for maturity and quality, the mature eggs are then transferred to a special culture medium. This medium is placed in a special incubator and after a few hours, it is fertilized with sperm. The two ways of fertilization are conventional and intra-cytoplasmic injection. The particular process to be used depends on the IVF team and other factors that relate to the couple that is doing the IVF.

Embryo transfer

Following fertilization, the time for the embryo transfer is fixed. It is usually decided by the IVF team and the couple. The timeframe, however, is between 1-6 days after the egg retrieval procedure. The number of embryos that are produced depends on various factors. The safest approach to embryo transfer is to limit the transfer to a single embryo. This prevents risks associated with multiple transfers like twins and triplets, which are associated with pre-term births and other complications. With an abdominal ultrasound for guidance, a small, thin, and flexible catheter is used to place the embryo into the uterus. It is placed in a position that maximizes its chance for implantation.

Pregnancy testing 

After about 12 days after the embryo transfer, a blood pregnancy test is carried out. If the test is positive, it is usually followed up with other blood tests and ultrasound imaging to confirm the viability of the pregnancy and in the case of multiple embryo transfer, the number of embryos that implanted.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *