DOCTOR'S VIEW ARCHIVE

Ectopic Pregnancy Risk After Tubal Sterilization

The fallopian tubes normally serve as transport passages for the egg (ovum) to meet the male sperm cell for fertilization. The fertilized egg then implants within the womb (uterus) to establish the developing embryo.

An ectopic pregnancy is a pregnancy that involves implantation of the fertilized egg outside of the uterus. The vast majority of ectopic pregnancies occur in the fallopian tube (95%). However, they can occur in other locations, such as the ovary, cervix, and abdominal cavity. Ectopic pregnancy can be dangerous and even fatal.

Sterilization by interrupting the fallopian tubes (tubal sterilization) is a common method of birth control (contraception). There are a variety of techniques available for tubal sterilization ranging from removing the tubes to clipping or tying (ligation), or electrically burning the tubes closed (coagulation).

Although pregnancy after tubal sterilization is not common, it can occur and may be ectopic.

In a report in the New England Journal of Medicine (1997;336:762-7), Herbert B. Peterson M.D. and associates reviewed the outcome histories of over 10,000 women who had undergone tubal sterilization.

Dr. Peterson's study found that while ectopic pregnancy after tubal sterilization is not common, it is also not rare. Many of the ectopic pregnancies occurred years after the sterilization procedure. They also occurred more frequently in women who had undergone the sterilization procedure before the age 30 years and in those who had histories of inflamed fallopian tubes (pelvic inflammatory disease).