?Can you serve as a surrogate after a tubal ligation? Yes! And in fact, many fertility clinics prefer working with gestational surrogates who have had their tubes tied. In this article, we’ll discuss the science behind why surrogacy after tubal ligation is not only possible, but preferable in many ways. We will also explore what it takes to become a gestational surrogate so you can decide if this journey is right for you.
What Is Tubal Ligation?
Tubal ligation, commonly referred to as getting your tubes tied, is a form of permanent birth control for women. It has a very high success rate for preventing pregnancy.
Women who choose to have a tubal ligation do so when they feel their families are complete or when they are certain they won’t want to become pregnant again. While the procedure can be reversed, the odds of a reversal being successful aren’t very good. Tubal ligation is only recommended for a person who is absolutely certain they don’t want to get pregnant again.
Tubal ligation is nearly 100% effective as a form of birth control, but it does not prevent menstruation or protect against sexually transmitted diseases. Also, because tubal ligation doesn’t affect a woman’s cycle or uterus, it’s still possible to become pregnant using in vitro fertilization (IVF). That means, yes, you can serve as a gestational surrogate even if you’ve had a tubal ligation!
According to Johns Hopkins Medicine, about 1 in 200 women do become pregnant following a tubal ligation. This typically happens due to timing: if an egg has already been fertilized prior to surgery, there’s a chance it could already be in the uterus ready to implant. Doctors recommend having the surgery immediately following your period to keep this from happening.
Tubal ligation is also referred to as female sterilization and is considered to be one of the most effective ways to prevent pregnancy. It is sometimes done to prevent ovarian cancer. Typically if the tubal ligation is done for this reason, the fallopian tubes are completely removed.
The Process Behind Tubal Ligation
The fact that a woman can become pregnant as a surrogate after tubal ligation surprises a lot of people. Let’s dive into the specifics of how tubal ligation works and why it still allows a person to become a surrogate.
“Tubal” refers to the fallopian tubes, and “ligation” means to tie off. Therefore, it’s a medical procedure that involves tying off the fallopian tubes. This procedure has to be done in a sterile surgical environment by a trained professional, either a hospital or an outpatient surgery center. Some women choose to have a tubal ligation completed following a caesarean section delivery since they are already in a surgical environment.
The goal of a tubal ligation is to block or tie off the fallopian tubes so your egg and your partner’s sperm cannot connect in order to fertilize the egg. During natural conception, a woman’s ovaries release the egg to travel through the fallopian tube. Sperm travels to the tube from the cervix and attempts to fertilize the egg. When your tubes are tied after a tubal ligation, the two cells have no opportunity to meet.
So what can you expect during a tubal ligation surgery?
First, you’ll be given fluids and medications via an IV so you can relax and become sleepy. The procedure can be done under general anesthesia (where you are fully asleep) or with local or spinal anesthesia, where you remain awake but fully numbed in your abdominal area.
Surgery is typically rather quick, about 30 minutes for the actual procedure. You’ll spend more time getting prepared for surgery and then in recovery.
Your surgeon will make a small incision near your belly button and sometimes in your lower abdomen in order to access your fallopian tubes. If you’re having the procedure done as an outpatient, he or she will use a laparoscope, which is a narrow tube containing a light and camera, in order to deliver long, thin instruments to locate and grab the fallopian tubes. If you’re having it done immediately after childbirth, the doctor will use the incision created during the c-section to access the tubes or will make a small incision following vaginal delivery.
The tubes will then be cut, tied, clamped, banded, or cauterized with an electric current. They can also be completely removed. Finally, the surgeon will close up the incision site using one or two stitches.
Most of the time, a patient is able to go home after spending just a few hours in the recovery room. Most women feel a little sore for a few days but are able to resume regular activity after a few days.
Complications are rare, but like all surgeries, there is some risk involved with a tubal ligation. Possible risks include:
- Ectopic pregnancy
- Bleeding at the incision site or internally
- Damage to other organs during surgery
- Incomplete closing of tubes that results in pregnancy
In general, tubal ligation is a very safe and effective form of permanent birth control. Be sure to talk to your doctor about all of the risks involved based on your personal health history.
The only other permanent birth control alternative to tubal ligation is a vasectomy for your male partner. Otherwise, you can explore other birth control methods such as an IUD, birth control pills, or other non-permanent methods.
Can You Still Serve As A Surrogate?
Yes, you can be a successful gestational surrogate after a tubal ligation! Let’s break down why this is true by first understanding how gestational surrogacy works.
Gestational surrogacy is a form of assisted reproductive technology (ART). As a gestational surrogate, you agree to become pregnant via IVF (in vitro fertilization) using an embryo created with someone else’s egg. Your own eggs are not involved, but because you still have a regular menstrual cycle after tubal ligation, your uterus is still ready to welcome a fertilized egg.
In gestational surrogacy, intended parents can have embryos created using their own gametes (egg and sperm), donor eggs, donor sperm, or donor embryos. The surrogate herself has no genetic connection to the child she will carry. Because of this, your eggs and fallopian tubes are not needed at all! The embryo will be created in the lab and then inserted directly into your uterus where it will hopefully implant and develop into a successful pregnancy. Learn more about becoming a surrogate.
>Benefits Of Being A Surrogate With Tubal Ligation
List benefits here and if it needs elaboration, then list it down as H3s.
Not only is surrogacy after tubal ligation possible, it’s seen as a major benefit by many surrogacy professionals! There are two main benefits to becoming a surrogate after tubal ligation.
Benefit #1: You’re Unlikely to Become Pregnant Naturally
The chance of you becoming pregnant with your own child before or during the surrogacy process is extremely low. While 1 in 200 women do become pregnant following tubal ligation, this amounts to less than 1% of all women who have their tubes tied.
A gestational surrogate whose tubes are not tied runs some risk of becoming pregnant naturally during the medical phase of a surrogacy journey. In the weeks leading up to the embryo transfer, a gestational surrogate needs to take fertility medications to prepare her body for pregnancy. This means that she is highly fertile during this timeframe. Usually, the surrogate is required to abstain from sex with her partner during this time to prevent natural pregnancy.
Though extremely rare, there have been cases of a gestational surrogate becoming pregnant with the implanted embryo and with her own child. There was a case in 2017 that hit the news and caused much discussion in the surrogacy industry. If you have had a tubal ligation, there is essentially zero chance of becoming pregnant with your own child via natural conception.
Benefit #2: You Have Completed Your Own Family
If you have had a tubal ligation, that’s a clear sign that you have committed to having no more children. This is perfect for someone looking to become a gestational surrogate because one of the prerequisites is that the surrogate does not intend to have any more children of her own. Surrogacy professionals won’t allow a woman to become a surrogate if she thinks she will want more children of her own in the future. This is because of the slight risk that becoming pregnant as a surrogate will affect a person’s future fertility. If you’ve had your tubes tied, your future fertility has become a non-issue.
Prerequisites To Be A Surrogate
Surrogacy is a noble and compassionate calling. It’s not an exaggeration to say that, as a gestational surrogate, you could be the answer to someone’s prayers. Because this is such a unique and special role to fulfill, there are several prerequisites you must meet in order to qualify as a gestational surrogate.
First and foremost is making sure you are fully aware of what’s involved. Becoming a gestational surrogate is not easy: you’ll be dedicating your body, time, and emotions to helping someone fulfill their dreams of parenthood.
Yes, there is compensation for your commitment, but there’s so much more to the journey than that, and there are more than a few hurdles you have to cross to qualify.
Can you be a surrogate? Here are the first questions you should ask yourself as you consider becoming a surrogate.
1. Do you live in a surrogacy-friendly state?
There are 3 states where surrogacy contracts are illegal and other states where it can be legally complicated. You can find details about your home state on this interactive map, but always be sure to consult with an attorney. Should you choose to work with an agency, you’ll likely be provided access to their in-house legal team.
2. Do you meet the health requirements for surrogates?
Gestational carriers (aka surrogates) have to be in great health and have a history of at least one healthy pregnancy. Intended parents are entrusting you with their child, so they need to make sure you’re physically and emotionally healthy enough to handle pregnancy and childbirth.
Some of the health qualifications for our surrogates at Family Inceptions include:
- Healthy BMI between 19-30
- No tobacco, alcohol, or drug use.
- No recent history of mental illness or use of medications for conditions like depression, anxiety, bi-polar, or PPD.
- History of uncomplicated pregnancies and deliveries (at least one, but no more than 5)
- No history of pre-term labor, pregnancy-induced hypertension, or preeclampsia
- Willingness to undergo extensive medical and psychological screenings
3. Are you financially stable?
You have to be financially stable and able to provide for your family without needing government assistance. The reason for this is to prevent women from seeking surrogacy as a means of making money. Yes, there is compensation involved for gestational surrogates, but that cannot be your sole motivation.
4. Is your family supportive and stable?
Finally, you will need to have the support of your partner and children. It also helps to have buy-in from close family and friends, as you will need a solid support system to help you throughout the pregnancy. While you do not have to be married or in a relationship to become a surrogate, you do need to have a stable relationship status. By that, we mean that you shouldn’t be expecting any major changes like an engagement, divorce, marriage, or separation in the foreseeable future.
If you do have a partner, he or she will have to participate in initial background checks, medical, and mental health screenings, and he or she will need to sign the surrogacy contract with you. Your partner will be your support person throughout this journey, so it’s vital to have them on board.
Read about all of the prerequisites here: Qualifications To Become A Surrogate.
>Understanding Tubal Ligation Reversal Surgery
Tubal ligation reversal surgery is possible, but it’s not always successful. This procedure is done with the goal of opening the fallopian tubes back up so a woman can attempt to become pregnant naturally, without IVF or other fertility treatments. It’s not always possible or available for everyone, though.
Your doctor will consider your age, BMI, health history, the type of tubal ligation that was done, and the current length of tube that still exists.
Some types of tubal ligation are easier to reverse than others. For example, if your tubes were clipped or banded with rings, or if only a small portion of the tubes were removed, then reversal could be successful. However, if your procedure used something like cauterization to scar and seal off the tubes, that is less likely to be successful. Of course, if your tubes were completely removed, a reversal will not be possible.
If your doctor determines that you are a candidate to try a tubal ligation reversal, then you’ll prepare much in the same way for the procedure. During the surgery, your doctor will either use a laparoscope or a small incision to access the fallopian tubes. The surgeon will then attempt to remove blocked portions of the tube and attempt to repair it with stitches.
Tubal ligation reversal is a longer and more complicated surgery than the initial tubal ligation. Reversal surgery takes 2-3 hours, and your recovery period may be longer.
According to WebMD, rates of a successful pregnancy vary wildly and are dependent on many factors like your age, your egg quality, your partner’s sperm count, and the health of the remaining fallopian tubes. Typical rates of success are between 40-85%.
here are some risks involved with a tubal ligation reversal surgery. Risks can include:
- Damage to internal organs
- Reactions to anesthesia
- Ectopic pregnancy (a fertilized egg implanted outside the uterus)
- Failure to get pregnant
Ectopic pregnancy is one of the more serious complications that can happen. Women who have had tubal ligation reversal are at a slightly higher risk than the general population. Following the procedure, there is a 3-8% chance of having an ectopic pregnancy. This is when a fertilized egg implants somewhere outside of the uterus, often in a fallopian tube. If left untreated, it can be life-threatening.
It’s also worth noting that insurance does not typically cover tubal ligation reversal. It is an elective procedure that can cost several thousands of dollars. Should you wish to become pregnant after having a tubal ligation, you may consider IVF as an alternative. Be sure to discuss all options with your doctor to decide what’s right for your situation.
Achieving A Successful Pregnancy
The goal of any gestational surrogacy journey is to achieve a successful pregnancy for the intended parents. If you have had a tubal ligation and are not considering a reversal, you may make the perfect candidate to help someone achieve their dream of parenthood. At Family Inceptions, we love working with women who have had tubal ligation surgery in the past, and we’d be honored to talk with you about what this journey may look like for you.