Unplanned pregnancies after tubal ligation may be “considerably more common than most people would expect,” says a study. New Analysis Based on nationally representative data from the United States.
A study led by scientists at the University of California, San Francisco found that more than 5 percent of people who undergo tubal sterilization are at risk of having an accidental pregnancy. Cutting, clamping, blocking, or removing the fallopian tubes.
In contrast, intrauterine devices and contraceptive implants Over 99 percent effective.
Given the large number of women in the United States expressing interest in permanent birth control, researchers argue that the actual effectiveness of all forms of tubal sterilization must be properly evaluated, especially since pregnancy after such a procedure increases the risk of an ectopic pregnancy — a pregnancy in which a fertilized egg implants and grows outside the uterus and can eventually become non-viable and pose a threat to the mother’s health.
“This study shows that tubal surgery may not be the best way to prevent pregnancy.” Conclusion Eleanor Schwartz, a general medicine physician at the University of California, San Francisco (UCSF).
“People who use arm-mounted birth control implants or IUDs are less likely to become pregnant than those who have had a tubal ligation.”
Tubal sterilization is one of the most common methods of permanent contraception in the United States, with more than 20% of women in their 30s and nearly 40% of women in their 40s having the procedure.
The patient Often guaranteed There is no longer a need to use additional contraception. In 2019, a woman became pregnant after having both fallopian tubes removed. said He was told the surgery would be “as close to 100% as possible.”
However, depending on how the procedure is performed, tubal sterilization may not permanently negate a person’s fertility.
Currently, the American College of Obstetricians and Gynecologists (ACOG) Reports The pregnancy rate for women after sterilization is about 1% over a five-year period, but this figure is based on a study that began in 1978 and ended in 1986.
The new data was collected from more than 4,000 Americans ages 15 to 44 who had their tubes tied between 2013 and 2015.
Schwartz and his team from UCSF, Johns Hopkins, Cornell, and UC Davis found that about 3 percent of participants became pregnant within a year of the procedure.
Ten years after tubal sterilization, the pregnancy rate was 8.4 percent.
This result is recent analysis A California study found that more than 2 percent of patients who had tubal sterilization became pregnant within a year, and more than 6 percent became pregnant within five years.
Since the first studies analyzing tubal sterilization failure rates in the 1980s, the surgical landscape in the United States has changed dramatically.
First, Schwartz and her colleagues explainthere was an introduction Hysteroscopic sterilization Salpingectomy, a procedure in which coils are inserted into the fallopian tubes to prevent eggs and sperm from meeting, became widespread, and subsequently the rate of salpingectomy, the complete removal of the fallopian tubes, also increased.
Is it safe to insert devices into the fallopian tubes? was asked seriously recent years, The most popular devices are being discontinued As of 2020, after having led to over 4,000 pregnancies since 2002.
Today, bilateral salpingectomy is considered the most effective method of tubal sterilization, but due to the limited data available, the failure rate of this new procedure is unknown. Unknown at this time.
First in history Documented cases A case of a woman who became pregnant after undergoing a double salpingectomy was reported in 2005. A second case was not published until another three years later.
It is thought that it is rare for an egg to pass through the space between the ovary and the uterus, but if remnants of the fallopian tube remain in place, Case Study This suggests that there may be an increased risk of unplanned pregnancy.
“When choosing the birth control method that’s best for them, people consider a variety of things, including safety, convenience, and how quickly they can start using the method.” explain Schwartz.
“For those who choose the ‘permanent’ method, finding out they’re pregnant can be extremely distressing. Unfortunately, we’ve found this to be a fairly common experience.”
Researchers are now eager to explore how different methods of tubal sterilization compare to each other in terms of actual failure rates.
“Our findings highlight the need for continued monitoring of the effectiveness of permanent contraceptive methods,” the authors write. Conclusion.
This study NEJM Evidence.
