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 their natural function, allowing sperm to reach and fertilize an egg.
- The procedure restores fertility in approximately 80 percent of women who have had tubal ligation surgery.
How is tubal ligation reversal performed?
We perform a mini-laparotomy, a type of microsurgery, to reverse tubal ligation.
- The procedure is carried out under general anesthesia at an outpatient center and takes approximately two hours.
- 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 through 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 deciding between tubal ligation reversal and in vitro fertilization (IVF) interventions to restore fertility, both the personal preference of the patient and the expert opinion of our doctors are taken into account.
Who should consider tubal ligation reversal?
When possible, we will provide the operative notes and pathology report from your previous tubal ligation surgery. This will provide important information to aid in determining if a potential tubal ligation reversal is right for the individual patient.
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 results of a sperm analysis
What if tubal ligation reversal is not an option?
If there is too little fallopian tube left after a tubal ligation surgery, reversal may not be possible. If tubal ligation reversal is not an option, 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 procedure restores fertility in approximately 80 percent of cases. The success of tubal ligation reversal is dependent on several factors. The most successful tubal ligation reversals are seen in patients:
- Who are younger than 40 years old.
- Who have three or more inches of healthy fallopian remaining after tubal ligation.
- With fallopian tubes that were originally blocked by clips, rings or minimally burned.
Even if the tubal reversal procedure is successful, you may need additional assistance to reach your goal of conceiving a child.
Risks and side effects of tubal ligation reversal
- Tubal ligation reversal procedure is conducted on an outpatient basis. Patients are usually discharged and sent home on the same day as their surgery.
- With mini-laparotomy reversal, 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 2–3 percent chance of ectopic pregnancy. This occurs when the fertilized egg implants outside of the uterus, usually within the fallopian tube.
Some insurance companies may cover a portion of the tubal ligation reversal. If your insurer is a carrier that will cover part of your surgical costs, please make sure they send the reimbursement check to you directly.
Contact us to schedule an appointment with our reproductive specialists to learn more about your options for tubal ligation reversal.