Tubal Ligation Reversal
It is estimated that 700,000 women undergo tubal ligation as a means of permanent contraception in the United States annually. In some cases, women may regret their tubal sterilization and desire the ability to conceive. Tubal ligation reversal and in vitro fertilization (IVF) have the potential to restore fertility for these women.
What is Tubal Ligation Reversal?
- Tubal ligation reversal is a procedure that reconnects the fallopian tubes in women who have previously undergone tubal ligation (tied tubes).
- Reconnecting the fallopian tubes restores the natural function of the fallopian tubes, allowing sperm to reach and fertilize an egg.
- The procedure restores fertility in approximately 80 percent of women.
How Is Tubal Reversal Procedure Performed?
- The procedure is carried out at an outpatient center and takes approximately two hours.
- Under general anesthetics, minimally invasive microsurgical techniques are preformed.
- The abdomen is accessed by a small (two inch) transverse incision. The fallopian tubes are identified and the area of blockage is surgically excised. The free ends of the fallopian tube are then carefully reconnected using a very fine suture.
- Once the fallopian tubes are reopened, sperm have the ability to travel along the fallopian tube and fertilize an egg. The egg then moves to the uterus for implantation.
- Even if the tubal reversal procedure is successful, it does not guarantee pregnancy.
Tubal Ligation Reversal or IVF?
In determining between tubal ligation reversal and IVF interventions to restore fertility, both the personal preference of the patient and the expert opinion of Dr. Servy are taken into account.
Is Tubal Ligation Reversal an Option?
When possible, we will provide the operative notes and pathology report from your previous tubal ligation surgery. This will provide important information and aid in determining the potential for tubal ligation reversal.
There are several factors that must be taken into consideration, as tubal ligation reversal is not appropriate for everyone. Factors include:
- Overall health of patient
- Age, weight and body mass index (BMI)
- The type of tubal ligation previously performed: Cautery, Hulka Clip, Fallope Ring, Pomeroy, Essure, etc.
- Remaining length of fallopian tubes
- The extent of damage to the fallopian tubes
- The condition of the fimbrial portion of the fallopian tube (area of fallopian tube closest to the ovaries)
- Other fertility factors such as sperm analysis
If Tubal Ligation Reversal is not an Option:
- A tubal ligation reversal can allow a woman who has had a tubal ligation to get pregnant without further medical assistance (without artificial insemination or in vitro fertilization).
- However, if tubal ligation reversal is not an option, in vitro fertilization (IVF) is an acceptable alternative.
- IVF involves retrieving mature eggs from the woman, fertilizing them with a man’s sperm in a laboratory dish and two to five days later the embryos are implanted in the uterus.
- The national pregnancy rate average for IVF has been reported as high as 40-45 percent depending on the women’s age.
Successful Tubal Ligation Reversal:
- The success of tubal ligation reversal is dependent on several factors.
- The most successful tubal ligation reversals are seen in patients:
- Less than 40 years old.
- Three or more inches of healthy fallopian remaining after tubal ligation.
- With fallopian tubes that were originally blocked by clips, rings or minimally burned.
- The procedure restores fertility in approximately 80 percent of cases.
- Even if the tubal reversal procedure is successful, you may need additional assistance to reach your goal.
- Tubal ligation reversal procedure is conducted on an outpatient basis. Patients are usually discharged home on the same day as their surgery.
- Patients may return to their normal activities 4 – 5 days post-operatively, with full recovery taking up to 2 weeks.
- Rare side effects of tubal ligation reversal surgery include:
- Anesthetic complications
- There is a two to three percent chance of ectopic pregnancy. This occurs when the fertilized egg implants outside of the uterus, usually within the fallopian tube.
- Total estimated cost: $ 5,770.
- This fee includes all of the following:
- Preoperative consultation
- Surgeons fee
- Anesthesia fee
- Operative facility fee
- Postoperative follow-up care
- Payments should be made by either money order or cashier check.
- All fees must be paid upfront in full, one month prior to surgery.
- Please be aware that cancellation of a procedure within 14 days of the surgery date will result in a 25 percent cancellation fee.
Will my insurance cover this?
Some insurance companies may cover a portion of the tubal ligation reversal. If your insurance is a carrier that will cover part of your surgical costs, please make sure they send the reimbursement check to you directly. Please note, the insurance code (ICD-9) for bilateral tubal occlusion is 628.2 and the procedure code (CPT) for tubal anastomosis is 58750. Our practice offers fee-for-service and does not accept payments from insurance carriers or file insurance claims.