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Pregnant After Tubal Ligation
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Joelle07 posted:
I had a tubal ligation November 14, 2008 when I had my son. I went to the doctor this week and found out that I am pregnant again... This time with TWINS!! I do not want any more kids and I know that there is less than a 1% chance of getting pregnant after a tubal ligation, but what are the odds of getting pregnant with twins after having this procedure? I am very interested to know the statistics for this.
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Jane Harrison Hohner, RN, RNP responded:
Dear Joelle: Most tubals are bilateral tubal ligations (BTLs), but there are a number of different techniques used and each has a different failure rate. One researcher looked at the 10 year cumulative failure rate for each type (Peterson, 1996):
Unipolar coagulation=0.75%
Postpartum tubal excision=0.75%
Falope or Yoon ring=1.77%
Not postpartum tubal=2.01%
Bipolar coagulation=2.48%
Hulka clip=3.65%

The time chosen for sterilization surgery is also a factor. BTLs done with clips or rings are less effective when immediately postpartum on dilated Fallopian tubes (Speroff, 1999).
Joelle, you should be able to get a copy of your records about your BTL so you can find out what type of procedure was done. Then talk with your OB/GYN or clinic to see if there were any other factors which may have predisposed you to the failure of your BTL. For example, women with adhesions (bands of filmy scar tissue from prior surgeries, endometriosis, pelvic infections, etc) may be more difficult to do a surgical BTL as the landmarks inside the abdomen can be harder to identify.

Multiple searches at the National Library of Medicine site yielded only seven citations. Most all of them reflected legal issues, not specific statistics. Here is one of the most recent, a case report from France:

J Gynecol Obstet Biol Reprod (Paris). 1994;23(8):932.
[Two twin girls, legal torts after a tubal sterilization failure, remain in the care of their parents, who were previously informed of this eventuality in writing. A decision of the administrative court of appeals in Nancy, September 30, 1993>
[Article in French>
Soutoul JH.
Clinique Gynécologique Universitaire du Beffroi, CHU de Tours

This month's blog was all about tubal liations, with a special section about causes of tubal ligation failure. From doing the research for that section I was surprised to see that failure was more common that one would think. Yet to have twins from a failure is VERY uncommon--I could not find any exact figures.

I am so sorry that you have had to deal with this. It's got to be hard. Thank you for taking the time to write so that other women can hear your story.

Yours,
Jane


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