Case Report: Tubal recanalization and short-term re-pregnancy after repeat ligation following two cesarean sections

Tubal ligation is a widely used permanent female sterilization method. Laparoscopic tubal recanalization offers a pathway to restore natural fertility for women who desire pregnancy after sterilization. However, short-interval re-pregnancy following repeat tubal ligation after recanalization is clinically rare.

We report a case of a 37-year-old woman, gravida 3, para 2, with a history of two previous cesarean sections, the second of which was accompanied by bilateral tubal ligation. Eight years after ligation, she underwent laparoscopic bilateral tubal recanalization due to remarriage and a renewed desire for childbearing. She conceived spontaneously 3 months postoperatively and delivered at 38 weeks via a third cesarean section, during which repeat bilateral tubal ligation was performed using the modified Pomeroy technique. Eleven months later, she conceived spontaneously again and underwent induced abortion due to no further fertility plans.

Although pregnancy rates after tubal recanalization can reach 80%-90%, repeat ligation following recanalization does not guarantee absolute contraceptive efficacy. Spontaneous re-canalization with subsequent pregnancy remains possible. This case highlights the importance of standardized surgical technique, long-term follow-up, and postoperative contraceptive counseling, particularly in patients with a history of tubal surgery.