Tubal Reversal

There are different reasons why you may have chosen to get a tubal ligation, also known as female sterilization. Perhaps you thought you didn’t want any children, ever. Maybe you had children and felt that your family was complete. Whatever the motive was behind your original choice of getting your tubes tied, there is only one reason you’ve changed your mind: you now want children.

Although deciding on a tubal ligation may seem like a permanent solution, as much as 25% of women who have had their tubes tied end up changing their minds. While there was a time when a tubal ligation reversal was impossible, thanks to the advances in modern medicine, today many women are able to get their tubes "untied" and conceive again.

When to Choose
Although it may seem easier to undergo in vitro fertilization, it is recommended that you look into tubal reversal first as there is a higher pregnancy rate with this procedure compared to IVF. However, not every woman is a candidate for tubal reversal.

To decide whether or not you are suited to this procedure, your fertility specialist will examine the current state of your fallopian tubes, usually through laparoscopy, as well as go over your surgery and pathology reports from the initial procedure. Other factors your doctor will consider when evaluating you include:

  • Which tubal ligation method was used to seal off your fallopian tubes (were they cut, tied, cauterized or non-surgically blocked?)
  • Where in your fallopian tube the sterilization took place
  • How much of your fallopian tube is left
  • The current health of your fallopian tube
  • Your age

Tubal Reversal Surgery
Traditionally, tubal reversals are a two to three-hour procedure done under general anesthesia. During the surgery, your doctor will unclamp, reattach or place an implant into your fallopian tubes, thereby making them functional again. Afterwards, you will need to stay in the hospital for at least one night and possibly up to five days. Full recovery can take from four to six weeks, though. Although rare, side effects of tubal ligation reversal surgery include:

  • Infections
  • Bleeding
  • Damage to the surrounding organs
  • Anesthetic complications

However, new advances in microsurgery have made it possible for tubal reversals to be done under local anesthesia in less than an hour and on an outpatient basis. Because the technique is less invasive than the traditional surgery, the risk of complications is significantly minimized and you’re able to return to your normal activities within five to ten days after the surgery. However, the technology is still quite new and not very widely offered in the United States.

Pregnancy After Tubal Ligation Reversal
The chances of conceiving after having a tubal reversal can be significantly better than trying to conceive through IVF. Using the traditional method of tubal reversal surgery, the pregnancy success rate ranges between 70 to 80% for those women under 40 years of age. Opting for the microsurgery procedure, however, can increase your chances of successfully conceiving to as much as 90%. Most women are able to successfully conceive naturally within a year of their surgery.

Unfortunately, though, there is a higher risk of experiencing an ectopic pregnancy if you have had a tubal reversal. While the risk of an ectopic pregnancy among the general population is about 1 in 100, this risk increases to 5 in 100 after undergoing a tubal reversal. If you have a confirmed pregnancy, make sure your doctor checks about whether it is ectopic.


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