A woman's question on Quora about a positive pregnancy test 20 years after tubal ligation and five years into menopause has raised medical curiosity. Over 190 million women worldwide depend on tubal ligation as contraception, a procedure that blocks, cuts, or seals the fallopian tubes. Although highly effective, the method is not entirely foolproof. According to a 2025 WebMD review, the failure rate is approximately 1.85% within 10 years, decreasing further with age. Dr Shaily Sharma, Senior Consultant Gynaecologist at Cloud Nine Hospital, explains that while pregnancy after such a procedure is extremely rare, it remains possible due to natural tube reconnection or other medical factors. She emphasizes the importance of medical evaluation when unexpected positive pregnancy tests occur, especially in postmenopausal women, as results can be misleading due to hormonal changes or underlying health conditions.
Understanding Pregnancy Risks and False Positives After Tubectomy
Dr Sharma clarifies that pregnancy following tubal ligation is exceptionally rare but feasible through a process called tubal recanalisation, where fallopian tubes naturally reconnect. Such pregnancies carry higher risks of being ectopic, requiring urgent medical attention. For women without menstrual cycles for over 12 months and in their late 40s, menopause is generally confirmed, making natural pregnancy impossible as ovulation stops. However, a positive pregnancy test could indicate a false positive. Postmenopausal women may produce low levels of human chorionic gonadotropin (hCG) from the pituitary gland, or conditions like ovarian cysts, trophoblastic disease, or certain cancers can elevate hCG. Medications containing hCG also contribute to misleading results. Dr Sharma recommends blood hCG tests and pelvic ultrasound for accurate diagnosis.
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