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What Are the Most Common Causes of Tubal Ligation Failure?

One of the most common causes of tubal ligation failure is an incorrectly performed procedure.
A diagram of the female reproductive system, including the fallopian tubes.
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  • Written By: A. Pasbjerg
  • Edited By: Heather Bailey
  • Last Modified Date: 17 June 2014
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Tubal ligation failure is a fairly rare occurrence, but when it does happen, it is typically the result of one of a few common causes. The procedure may be performed incorrectly, leaving a passage for the egg and sperm to travel through. In certain cases, the ends of the tubes may grow back together. When the fallopian tubes are closed off using clamps or rings, those devices may come loose or slip out of place, re-opening the tubes. Women may also be unable to get pregnant normally but be more prone to ectopic pregnancies after tubal ligation.

One of the most common reasons for this procedure to fail is it being performed incorrectly. If the surgeon is not skilled enough to perform the ligation correctly, or runs into problems with a necessary instrument such a laparascope, the tubes may not be totally closed off. They may be left partially unblocked, or the devices used to hold them closed may be placed in the wrong location. Women with certain physical conditions, like obesity or pelvic adhesions, may also be harder to perform the procedure on correctly. Sometimes, the surgeon may incorrectly tie off the round ligaments near the uterus because they are mistaken for the fallopian tubes.

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Another issue that commonly causes failure is re-attachment of the tubes. This process, called spontaneous reanastomosis, can occur if the ends of the severed tube are not separated far enough apart. There may also be issues with the sutures used in the procedure that allow the ends to grow back together. In some cases, a fistula or endometriosis may form where the tubes were cut and create a passageway between them.

Women who have certain types of procedures are more likely to experience a tubal ligation failure than others. Devices like rings, loops, or clamps that hold the tubes closed but do not actually damage them can be placed incorrectly or may slip so they are no longer fully blocking the passage of sperm or eggs. Procedures that do more to damage the tubes by actually cutting, scarring, or burning them are much less likely to fail.

Although the tubal ligation procedure may stop passage of an egg, if there is even a tiny passage left open, smaller sperm may be able to make their way through. This can result in an ectopic pregnancy. Not only is this a failure of the procedure, it can also be potentially life threatening to the woman.

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Discuss this Article

anon318068
Post 9

I had a sterilisation procedure five years ago at the age of 40, having decided that I didn't want children. Last year, after severe abdominal pain on my left side, I had an X-ray which showed my left clip was residing in my right rib cage. I was obviously concerned, but a gyno consultant said that this was not uncommon and I had nothing to worry about. How does he know without dye tests that my left tube is closed? I am very worried and anxious.

anon315372
Post 8

I had my tubes clamped in 2008 (or so I thought). In 2010 I found out I was pregnant. After the birth of my son, I went to a specialist to see which tube was open. Come to find out the right tube was never clamped.

anon295121
Post 7

I had my tubes clipped five years ago and now my periods are heavier. But recently I have been getting the most horrible tummy pains like labor pains. They bring me to my knees and I can feel something in my tummy when I touch it. Could this be my clips that I feel? Should I go to the doctor or will I be wasting their time?

anon276891
Post 6

My friend had a tubal litigation for four years and was just surprised this month that she is two months pregnant. Can you give us any advice about what we should do? And to the doctor who did her operation?

MissMuffet
Post 5

@Domido - my friend had a tubal litigation done because it was the right decision at that point in her life. Sadly she later divorced, and met another guy who she wanted to have children with.

She spent ages praying and hoping to be one of the few whose tubes somehow join together again, which the doctors thought may happen because she'd been quite young when the operation was carried out. (Evidently age, plus the type of procedure chosen by the surgeon make a difference.)

In the end she opted to have surgical intervention. You are right to say that the reverse procedure isn't easy, and it carries a risk of any consequent pregnancy being ectopic. But for some women it is worth the risk.

This story has a happy ending, as she added twin girls to her family and both were born naturally, without any complications at all.

yumdelish
Post 4

@Oscar23 - I feel sorry for the poor woman you described. Who wants to deal with all that gossip on top of the shock of a late and totally unexpected baby?

I suppose the good thing was that it wasn't her husband who was sterilised, or there would have been even more tattle telling!

My sister had a tubal tie and was given a lot of information about the possible failure of this procedure. Overall though it is better odds than most forms of contraception. I think you just need to remember that nothing is 100% reliable, except abstinence!

poppyseed
Post 3

Getting your tubes tied is not a real simple matter, and it is something that shouldn’t be taken lightly.

My mother had this done after she gave birth to her fourth daughter, and I can’t say that I blame her. Bless her heart, four is a plenty and the last two were not planned in the least.

However, I personally think that it is something that should be strongly considered before going forward with it; particularly for young women or women with only one child.

Also, if you are in a monogamous relationship, your partner should certainly have a word to say about it. I know that we are in an age where it’s the woman’s body and her choice; I get that and I respect that.

However, if you are in a monogamous relationship you are your partner’s only option if he wants to have more children in the future. It’s just appropriate to make the choice together.

Of course, neither person should beat the other about the head with something that the other simply doesn’t want. In the end, it is the woman’s ultimate choice.

Domido
Post 2

Although tubal ligation is a normally effective form of birth control for people who know that they don’t want any other children, it is not one hundred percent effective either.

It is also not very easy to reverse in any case.

It used to be a very difficult procedure that was a full-fledged operation. I’ve heard recently, however, that now there is some variation of the procedure that can be performed as outpatient surgery similarly to the vasectomy.

(A vasectomy is more or less the male equivalent to tubal ligation.)

Diverse people feel differently about both concepts. Some feel that by cutting off the way that their body’s procreate (men and women alike) that they are somehow less of themselves.

I, however, only have reservations because of the fact that I know I might change my mind about having children later in life. I would hate to have that option altered more than pure aging does to begin with.

oscar23
Post 1

I live in a small town, and everyone here knows everyone’s business. It can be a little frustrating at times, but it can also lend a good amount of comfort to know the people around you.

Regardless, the whole town was all in an uproar a few years back when a mother of four suddenly came up pregnant when her last child was in high school.

She was in her forties when it happened. (Early marriage and door-step babies make this possible.)

Being that we do live in a very small community, we all knew she’d had tubal ligation. It was supposed to be this big secret, though.

Everyone was confused. Nobody could really accuse her of anything bad, because it wasn’t her husband that had the procedure.

It was a big mystery at first, and the lady herself was pretty upset. Come to find out, her tubes had indeed been tied, but by some strange coincidence, they had grown back together.

So now, she and her husband have grandchildren that are about the same age as their baby boy.

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