Pregnant Despite Tubal Ligation: New Data Calls Permanent Contraceptive Method into Question

It has always been considered a permanent contraceptive methodbut now a new American study calls into question its absolute efficacy, demonstrating that Pregnancy can actually occur in more than 5 percent of women who have undergone bilateral tubal occlusion. (OTB), the so-called tubal ligation.

The study, published in The New England Journal of Medicineused data from the National Survey of Family Growth, which examines contraceptive use, pregnancy, and birth outcomes in a representative sample of U.S. women ages 15 to 44. The data were collected at four points in the lives of 4,000 women who had tubal ligation between 2002 and 2015. Most of the women surveyed reported having the procedure after giving birth because they wanted to be childless.

Further analyses of data from the National Survey of Family Growth found that tubal ligation was the most popular method of “permanent” sterilization in the United States, used by 22.4 percent of women of reproductive age in 2016. Despite such widespread use, however, the researchers in the current study found “nontrivial pregnancy rates” after such procedures.

Between 2.9 and 5.2% of women studied reported becoming pregnant after a tubal sterilization procedure, and between 12.1 and 32.6% of participants reported having an ectopic pregnancy. Women who underwent postpartum procedures were less likely to report a subsequent pregnancy after tubal sterilization, and older patients were less likely to report a pregnancy after the procedure than their younger counterparts.

Non-trivial pregnancy rates after surgery

Pregnancy rates after tubal sterilization “were not trivial and may be considerably more common than many expect,” the researchers wrote. “When considering which contraceptive method will work best for them, women consider a variety of factors, including safety, convenience, and how quickly they can begin using the method,” Eleanor Bimla Schwarz, MD, chief of the Division of General Internal Medicine at UCSF Zuckerberg San Francisco General and the study’s first author, said in a press release. “This study demonstrates that tubal surgery cannot be considered the best way to prevent pregnancy.”

Two other methods are more effective

According to the specialist, women who use a subcutaneous contraceptive implant (a 4 cm long and 2 mm thick stick which, inserted under the skin of the arm, progressively releases a hormone similar to progesterone which prevents ovulation and therefore pregnancy) or one IUDthe progesterone coilare less likely to get pregnant than those who have their tubes tied.
At the same time, researchers highlight the importance of further research into the actual effectiveness of the different forms of contraception currently available.