IVF after sterilization in women, when fallopian tubes are tied

For a woman who has had a Tubal Ligation (a fallopian tube retraction), IVF is the only true solution for conceiving a child. There is another way, but it is not always effective. Surgery can be performed to restore the patency of the fallopian tubes. Nevertheless, there are frequent cases when after scarring, the tubes become obstructed again, and the woman becomes sterile.

ultrasound pregnancy

IVF after sterilization in women is more effective than in vitro fertilization in all other patients. This is due to the fact that they were initially already fertile (have children), they usually have a normal hormonal background and endometrium.

Let's understand why normally functioning fallopian tubes are necessary for a natural pregnancy and why they are not needed for IVF.

A woman's natural fertilization process proceeds as follows:

  1. A mature egg cell matures in the woman's ovaries. It exits into the fallopian tube (this anatomical structure is located between the ovary and the uterus).
  2. After sexual intercourse, the man's spermatozoa enter the woman's vagina. They enter the uterus and then the fallopian tube and move toward the egg.
  3. Fertilization occurs when the sperm and egg meet in the fallopian tube. But if it is impassable, this meeting becomes impossible and pregnancy does not occur.

IVF fertilization does not take place in the fallopian tube, but in a test tube. A woman's egg (or several eggs) is extracted from her ovary through a procedure called a follicle puncture. It is fertilized with the husband's sperm, cultured in a nutrient medium, and then the embryo is placed in the uterus at the age of 3-5 days.

Thus, IVF after tubal sterilization is the best way for a woman to achieve pregnancy. The likelihood of success is not diminished by the earlier surgery. The younger the woman and the better the functional state of her reproductive system, the higher the chances of conceiving a child through in vitro fertilization.

infographic about the chances of getting pregnant during folopian tube sterilization

Tubal infertility: what it is and why it happens

Tubal infertility is a condition in which a woman is unable to conceive on her own due to obstruction of the fallopian (fallopian) tubes.

Is pregnancy possible without tubes? To answer this question, we need to consider their structure and physiological purpose.

Fallopian tubes is an organ located in the pelvic area and has an important function in the process of conception: its inner villi capture the oocytes that came out of the ovary during ovulation. It is here they are fertilized by sperm. The egg is then guided through the fallopian tubes to the uterine cavity, where it is fixed.

There are life stories of pregnancy without tubes, but these are isolated and far from successful cases.

The obstruction of this paired organ occurs when there are scars, adhesions or fluid in its lumen that prevent the egg from entering the uterus, and also as a result of its deformation or kink due to the presence of adhesions in the abdominal cavity and the pelvic area.

The pathology is associated with such causes as:

  • surgical terminations of pregnancy;
  • Sexually transmitted infections (gonorrhea and chlamydia, which provoke inflammation of the fallopian tubes, are particularly dangerous);
  • Gynecological surgical interventions in the anamnesis;
  • Hormonal imbalance;
  • gynecological diseases (uterine myoma, endometriosis, fibroids).

In some cases, surgery is performed to remove the fallopian tubes. Such surgical intervention is called salpingectomy or tubectomy. It is performed when there are pathological changes in one or both fallopian tubes caused by:

  1. Ectopic pregnancy accompanied by internal hemorrhages. (An ectopic pregnancy without removal of the tube can occur if the embryo attachment site is close to the exit of this organ).
  2. The accumulation of large amounts of blood or purulent exudate in their lumen. 3.
  3. The formation of large cysts or rough adhesions that cannot be removed.
  4. Malignant neoplasms of the uterus or its appendages.

Pregnancies after tubal ligation are rare in the history of medicine, and only one case has resulted in a successful birth.      

Women diagnosed with tubal infertility can benefit from modern assisted reproductive technologies. A pregnancy without tubes is possible thanks to the method of in vitro fertilization (IVF), in which an egg is fertilized "in vitro", i.e. in a test tube, and then transferred artificially to a woman's uterus. This method is effective even if both tubes are removed, but at least one ovary remains.

The IVF method was pioneered in 1978 by British scientists. On July 25, 1978 "Test-tube baby girl" Louise Brown was born, who gave birth to a child conceived naturally in 2004. Since then artificial insemination has been widely used in cases of female or male infertility. The success rate of IVF without fallopian tubes on the first attempt is 35-40%. The result directly depends on the patient's age: the younger she is, the better the chances are.

Cost of IVF  when fallopian tubes are tied

Service name Cost, EUR
In Vitro Fertilization (with ICSI, no medications) 1090 EUR
Infertility treatment program by IVF method "Optimal 2345 EUR
Pre IVF screening 350 EUR
Fertiloscopy diagnostic 320 EUR

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