I tied my tubes, can I still get pregnant?
Dear Dr Mitchell,
I have a daughter who is 10 years old. I had my tubes tied over five years ago. I just got married almost a year ago and I want another baby with my new husband. He has no children and he has a very low sperm count. Is it possible to do anything?
Tubal ligation is a permanent surgical procedure that is used for female sterilisation. Patients are usually counselled before that largely speaking, this is an irreversible procedure.
However, depending on the method of tubal ligation and also the amount of fallopian tube that is removed, it might be possible to do an operation to reverse the tubal ligation. This is a major surgical procedure and there are possible complications that can result from the anaesthesia from the surgery itself. There is no guarantee that having done this, that you will become pregnant. This is because there may be considerable scarring at the site where the tubes are formed together and despite the use of good surgical techniques, the tubes remain permanently blocked. There is also an increased risk of having an ectopic pregnancy. An ectopic pregnancy is one which is implanted outside of the cavity of the uterus. The most common site for this to occur is in the fallopian tubes. This can be a life-threatening emergency since the tubes can burst open suddenly, leading to shock from blood loss and possible death.
The other option for you is to do invitro fertilisation. This might be the better option instead of reversal of tubal ligation, since your husband’s sperm count is low. Invitro fertilisation is a special procedure where the ovaries are stimulated using special hormones and the eggs are removed under local anaesthesia using ultrasound as a guidance to locate the ovaries. The semen is then obtained from the man and used to fertilise the eggs. At an appropriate stage, the embryo is then transferred into the uterus and subsequently implants itself into the cavity. The outcome from this is usually very good especially if you are under 40 years old. You also have the opportunity of having a subsequent pregnancy later on from left over embryos which are specially preserved and kept in the lab.
Women over 40 years who have poor quality eggs have a poor outcome from in vitro fertilisation (IVF) but can still conceive if they use donor eggs from an appropriate donor.
In addition, if your husband is not opposed to it, you can also do IVF and use donor sperms if his sperm quality is also poor. There is a well-equipped IVF facility at the University of the West Indies and this has afforded women who would not have otherwise had a chance to have a child, the opportunity to conceive. The results are comparable to facilities in first world countries and the cost is significantly less.
Consult your gynaecologist or family doctor who will give you more details and refer you to the Fertility Management Unit for counselling about possible invitro fertilisation or reversal of your tubal ligation.
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions and comments via e-mail to allwoman@jamaicaobserver.com or fax to 968-2025. We regret that we cannot supply personal answers.
