Tubal Ligation Reversal
Before the tubal ligation reversal
What is required prior to surgery?
During the tubal ligation reversal
After tubal ligation reversal
What are the risks of tubal ligation reversal?
Pregnancy success rates after reversal
Good candidate tubal ligation reversal
In a tubal ligation, also known as “having your tubes tied,” your fallopian tubes are cut or blocked. Fertilization happens in the fallopian tube, so a tubal ligation prevents pregnancy by keeping the sperm and egg from meeting.
Some women who have had a tubal ligation might choose to have it reversed. A tubal ligation reversal reconnects the blocked or cut segments of the fallopian tube. This allows a woman who had previously had her tubes tied to become pregnant naturally. This procedure is also known as a tubal reanastomosis, tubal reversal, or tubal sterilization reversal.
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A tubal ligation reversal may allow you to get pregnant without further medical assistance.
A tubal ligation reversal isn’t appropriate for everyone. Your health care provider will consider several factors to determine if tubal ligation reversal is likely to be successful, such as:
- Your age and body mass index
- The type of tubal ligation
- The extent of the damage to your fallopian tubes
- Remaining tubal length
- Other fertility factors, such as sperm and egg quality
The success of a tubal ligation reversal procedure depends on a variety of factors. It’s more likely to be successful if you still have a large portion of healthy fallopian tube remaining.
Tubal ligation reversal is more likely to be successful if your tubal ligation was originally done using clips or rings, rather than if segments of your fallopian tubes were burned in order to close them off (electrocautery). Some types of sterilization, such as the Essure or Adiana systems, aren’t considered reversible.
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Before the tubal ligation reversal
Your doctor will likely suggest you and your partner get a complete physical exam. That way you can find out if there’s anything that might keep you from getting pregnant after a tubal reversal.
Your exam may include blood and imaging tests to make sure your ovaries are normal. You’ll also need a test called a hysterosalpingogram (HSG), to check the length and function of your remaining fallopian tubes. An HSG can be done using dye and X-rays or saline and air along with ultrasound.
Your doctor may also suggest that your partner get tests such as a sperm count and semen analysis to rule out any fertility problems.
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What is required prior to surgery?
- medical history and physical examination
- male partner’s sperm analysis
- copies of your operative report and pathology reports for the sterilization procedure at the time of your initial office visit will be helpful
- You may also be required to have additional x-rays, blood work and/ or fertility tests prior to surgery.
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During the tubal ligation reversal
First, your doctor will look at your fallopian tubes using a laparoscopic camera. This is a small camera put into your abdomen through a tiny slit. If your doctor sees that you have enough fallopian tube left to reverse your tubal ligation, and everything else looks healthy, they’ll perform the surgery.
Most tubal ligation reversals are done with laparoscopic surgery. This means the surgeon will make several small slits in your abdomen (the largest being approximately ½-inch long), then put in a camera and small instruments to do the surgery. They’ll control these from outside your abdomen. This takes approximately two to three hours, and you’ll need general anesthesia.
Your doctor will remove any damaged sections of your fallopian tubes and any devices from the tubal ligation, such as clips or rings. They’ll then use very small stitches to reattach the undamaged ends of your fallopian tubes. Once the tubes are reconnected, the surgeon will inject a dye into one end of each tube. If no dye leaks out, that means the tubes have been reattached successfully.
In some cases, your surgeon might use a procedure called a minilaparotomy. Your surgeon will make an incision in your abdomen, usually about 2 inches. They’ll then take the ends of the fallopian tube out of your abdomen through the slit. The surgeon will remove damaged parts of the fallopian tube and reconnect the healthy sections while the tubes are outside your body.
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After tubal ligation reversal
You can slowly resume your normal activities as you begin to feel better, which usually takes one or two weeks. Your stitches will dissolve and won’t require removal.
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What are the risks of tubal ligation reversal?
Risks associated with a tubal ligation reversal include:
- An inability to get pregnant after the procedure. Pregnancy rates following reversal of tubal ligation vary greatly depending on a woman’s age and other factors.
- Infection.
- Bleeding.
- Scarring of the fallopian tubes.
- Injury to nearby organs.
- Anesthesia complications.
- Ectopic pregnancy — when the fertilized egg implants outside the uterus, usually in a fallopian tube.
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Pregnancy success rates after reversal
If your remaining fallopian tubes are healthy, and you and your partner don’t have any other infertility issues, you have a good chance of getting pregnant after tubal reversal.
Keep in mind, though, that it doesn’t work for everyone. Age plays an important role in whether you get pregnant after tubal reversal. Older women are much less likely than younger women to have success.
In general, pregnancy success rates range from 40% to 85%. When pregnancy does happen, it’s usually within the first year.
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Good candidate tubal ligation reversal
Factors that can make a tubal ligation reversal more likely to be successful include:
- The type of tubal sterilization. Some types of tubal sterilization are not reversible.
- How much of the fallopian tube is left undamaged. Reversal surgery is more successful when there’s a lot of healthy fallopian tube left.
- Age. Reversal is more successful in younger women.
- Body mass index. Reversal may be less successful if you’re obese or overweight.
- Other health conditions. Other health conditions, such as autoimmune diseases, can affect pregnancy. If you have one of these conditions, your doctor might take that into account when deciding if a tubal ligation reversal is right for you.
- General fertility. Having general fertility problems makes tubal ligation reversal less successful. Prior to surgery, your doctor will probably test both you and your partner to learn more about your sperm and egg health. Your doctor might also take images to make sure your uterus can support a pregnancy
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Factors to consider:
- Age: Women who are younger than 40 are more likely to become pregnant after reversal than women who are 40 or older.
- Ovarian reserve testing results: Ovarian reserve testing measures your remaining supply of eggs and helps you and your fertility team better understand how likely it is that you will be able to become pregnant.
- Type of tubal ligation: There are several different ways to perform tubal sterilization. The type of procedure you had may affect how likely reversal is to be successful.
- Partner sperm health: Men with low sperm counts, below 20 million sperm per milliliter, or low sperm motility may require in vitro fertilization (IVF) in order to father a pregnancy and are not good candidates to have their partner undergo a tubal ligation reversal.
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Is the operation covered by insurance?
Please check with your individual insurance carrier to determine if this procedure is covered, since often times this procedure is not covered.
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