If you’ve tied your tubes, you aren’t alone. Between 2021 and 2022, 4.8 million women had tubal ligations, or “their tubes tied,” according to a report published in JAMA. There are a lot of good reasons to tie your tubes: bodily autonomy, wanting a permanent birth control option, preventing ovarian cancer, or all of the above. After tying your tubes, it’s still possible to get pregnant through IVF (either with your own eggs or donor eggs) or by having a tubal ligation reversal procedure.

What is a tubal ligation?

It’s a procedure where a doctor cuts or blocks your fallopian tubes as a form of permanent birth control. When the fallopian tubes are blocked or cut, sperm can’t connect with and fertilize an egg inside your body. 

Tubal ligation is different from a bilateral salpingectomy, where the tubes are completely removed. If you have had a bilateral salpingectomy, it can’t be reversed, and it’s only possible to get pregnant with IVF.

Why do so many women tie their tubes?

Having a permanent birth control option — without hormones! — is very appealing for many people. Some people tie their tubes because they don’t ever want to have children, and others choose to undergo a ligation after they finish building their families. For people who don’t want to be able to get pregnant, a tubal ligation is a reliable form of non-hormonal birth control. 

People also tie their tubes for medical reasons, including to reduce the risk of ovarian cancer later in life. In particular, people with the BRCA gene mutation are often advised to tie their tubes to lower their risk of ovarian cancer. 

Do you still get your period after getting your tubes tied?

Yes. Tying your tubes doesn’t prevent you from ovulating, and your body will reabsorb the egg when it reaches the blocked off point of the fallopian tube. The uterine lining will still shed monthly (approximately — everyone’s different), and you’ll still get a period.

Does tubal ligation prevent STIs?

No. It’s important to practice safe sex and use a condom if you and your partner, if you have one, are non-monogamous.

Can you still get pregnant from penetrative sex after a tubal ligation?

Yes, but it’s incredibly rare — pregnancy rates are between .4% and 1%, which puts it on par with hormonal contraception. 

What happens in the procedure? Is anything actually getting tied?

There are a few different ways to perform a ligation, depending on when it’s being performed, like if it’s shortly after giving birth vaginally. Depending on the type of procedure, your doctor will make a small incision (or two) in the abdomen to get access to the fallopian tubes, cut and close off the tubes, and stitch you back up. It’s usually an outpatient procedure that takes about half an hour, and most people can go home the same day.  

Fallopian tubes can be cut and cauterized, banded or clipped, or cut and tied shut with sutures, according to the Cleveland Clinic so, technically, they can be tied, depending on the technique your doctor uses.

What if you decide you want to get pregnant after tying your tubes?

Circumstances change, and there are still options to get pregnant, albeit expensive ones. You can still get pregnant through IVF treatment. 

Let’s go back to health class for a second: An egg moves down the fallopian tube to the uterus, and if it meets sperm, it can fertilize and become an embryo, and eventually, a pregnancy. A tubal ligation prevents this from happening by severing the connection between the fallopian tube and the uterus.

When a person goes through IVF treatment, they use medication to stimulate their ovaries to produce more follicles and eggs, and a doctor retrieves those eggs by going directly through the ovary, so there’s no need to access the fallopian tubes. Then, after the eggs are fertilized in a lab, they’re transferred directly to the uterus, also bypassing the fallopian tubes. So, if you go through IVF, it’s possible to bypass the fallopian tubes altogether and carry a healthy pregnancy to term.

Another less common option is to go through a tubal ligation reversal procedure, which allows about half of women to get pregnant again, according to Mount Sinai. A tubal ligation reversal procedure typically isn’t covered by insurance, and it costs between $5–10,000. 

Wrapping up

Tying your tubes is a big decision. If you’re considering it, talk to your doctor, especially if you might want to continue building your family in the future. 

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