Tubal Ligation, Gastric Bypass and Pregnancy

Thank you for your question. Tubal ligation—especially when the tubes are cut, tied, and cauterized—is considered a highly effective and permanent form of birth control. However, no sterilization procedure is 100 percent guaranteed. The risk of pregnancy after tubal ligation is small but not zero; studies estimate long-term failure rates between 0.5 and 1 percent.
Having undergone a Roux-en-Y gastric bypass does not, by itself, increase the likelihood of pregnancy after a tubal ligation, but it does mean that if pregnancy were to occur, it would require close medical monitoring. Occasionally, the fallopian tubes can reconnect (called tubal recanalization) or form a passage that allows fertilization, and if that happens, there is also a higher risk of an ectopic (tubal) pregnancy, which can be dangerous and requires urgent care.
If you suspect pregnancy or have symptoms such as missed periods, abdominal pain, or unusual bleeding, you should take a pregnancy test and contact your doctor immediately. For women who have had bariatric surgery, it’s also important to discuss contraception with your healthcare provider, since nutrient absorption changes can affect the effectiveness of some oral contraceptives.
In summary, while pregnancy after tubal ligation is very uncommon, it is not impossible. If you have concerns or are experiencing symptoms, seek evaluation promptly to ensure your safety and discuss reproductive options if needed.

If you had a tubal ligation in the past then you will be unable to get pregnant after a gastric bypass. Gastric bypass surgery does improve infertility due to hormonal changes in the body. You have to wait at least one year after bariatric surgery to get pregnant because you cannot support a fetus with massive weight loss. If you would like to get pregnant again you have to go to a gynecologist to reverse the tubal ligation.

If your tubes are tied they will stay tied.  The bypass is unrelated.  Obesity is a common cause for infertility.  This is typically reversed after surgery and weight loss.  However, I recommend waiting at least 1 year after weight loss surgery prior to getting pregnant.