Tubal Ligation Reversal
Most women who undergo tubal ligation, or surgical sterilization, do so with the intention of not having any more children. However, sometimes a shift in circumstances can influence a woman to change her mind and decide she wants to become pregnant again. Fortunately, medical technology provides certain options that can make this possible, one of which is tubal ligation reversal.
Prior to a tubal ligation reversal, couples must undergo a series of tests to ensure that additional issues will not interfere with achieving conception after the surgical procedure. Blood tests will be used to ensure that ovulation is still taking place and a hysterosalpingogram (a test that involves the introduction of an X-ray-sensitive dye into the uterus and an examination of its progress outward into the fallopian tubes) is performed. This ensures that no scarring or additional blockages exist in the fallopian tubes that may prevent the surgery from being successful. The male partner will be asked to undergo semen analysis as well.
Tubal Anastomosis
Once it has been determined that there are no additional obstacles to fertility, the tubal ligation reversal procedure may proceed. Because direct access to the fallopian tubes is required, this procedure cannot be done with endoscopic equipment, but necessitates a laparotomy, or open abdominal surgery.
Once the tubes are accessed, the closed ends are re-opened, and a thin, flexible stent is passed through both sections of the fallopian tube to provide stability and ensure that the opening remains unobstructed through the surgical process. The separated ends of the tube are drawn together and very fine sutures are used to reconnect the muscular layer of the tube first, followed by the outer layer. The delicate, innermost layer of the tube is left undisturbed. Once the stitches are complete, the stent is gently removed and the outer incisions are closed.
Recovery
After the procedure, the patient will remain overnight in the surgery center’s recovery area. Once the patient has been discharged, there will be a period of limited activity for approximately three weeks, while the body is given time to heal. Detailed pre- and post-operative instructions will be provided to the patient prior to surgery. Any questions you may have about specific activities should be directed to your surgeon.
Candidacy
Unlike vasectomy reversal, the success of tubal ligation reversal is unaffected by the length of time since the sterilization procedure was performed. However, the particular method used in the original procedure is paramount. Women who have had their tubes closed off with the use of clips or rings have a very high chance of success with tubal anastomosis (about 70 percent). If the tubes have been burned or cut, the success rate drops to about 50 to 60 percent. Unfortunately, if the fimbriated ends of the tubes have been removed, the chances of a successful reversal are very low and In Vitro Fertilization (IVF) is recommended instead. If you are able to provide our infertility specialists with a copy of the operative report from your sterilization procedure, it will significantly improve our ability to determine your candidacy for tubal ligation reversal. We will also discuss the success rate of the procedure based on your age and egg numbers.
Revised 12/2023
