‘I am 48, have my tubes tied for 20 years and haven’t had a period for over 5 years; but a pregnancy test came back positive. Is it possible that I am pregnant?’

One such woman took to the online forum Quora, sharing her experience of having a positive pregnancy test after 20 years of tubal ligation and 5 years of menopause. Curious, we reached out to Dr Shaily Sharma, Senior Consultant Gynaecologist, Cloud Nine Hospital, seeking answers.

Many users post their queries on the online platform Quora, seeking medical advice

Q: Is it medically possible for a woman to become pregnant decades after a tubal ligation?

Dr Sharma points out that pregnancy after tubal ligation is extremely rare but not impossible. Even though the procedure is meant to be permanent, in some cases, the “fallopian tubes can naturally reconnect (a process called tubal recanalisation), allowing an egg and sperm to meet.” So while the risk of pregnancy is very low, it can occur even years later. “If pregnancy happens after tubal ligation, it carries a higher risk of being ectopic (outside the uterus), which requires immediate medical evaluation,” the gynaecologist warns.

Q: If a woman hasn’t had a period for over 5 years, does that confirm menopause, or could pregnancy still occur?

“If a woman hasn’t had a menstrual cycle for 12 months or more and is in her late 40s, it generally indicates menopause,” Dr Sharma notes. She explains that after menopause, natural pregnancy is not possible because ovulation ceases. “However, if a pregnancy test turns positive, it’s important to consult a doctor immediately to confirm the cause, as it could be due to other medical factors rather than actual conception,” she recommends.

Q: Can a positive pregnancy test in such a case indicate a false positive, and what medical conditions can cause that?

Dr Sharma affirms that in such cases, positive pregnancy tests could be a false alarm. “In postmenopausal women, low levels of human chorionic gonadotropin (hCG) can be produced by the pituitary gland, leading to a misleading positive result. Certain medical conditions, such as ovarian cysts, trophoblastic disease, or rarely, some cancers, can also elevate hCG levels,” she further clarifies. Additionally, medications containing hCG could also lead to these false positives. “Therefore, further testing — including a blood hCG test and pelvic ultrasound — is essential to determine the true cause of the result,” Dr Sharma concludes.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.