Tubal Ligation Reversal

Tubal ligation reversal at a glance

  • Tubal ligation reversal surgery reopens or reattaches a woman’s fallopian tubes that have been “tied” or blocked in a previous sterilization, in order to reverse that and allow a woman to potentially get pregnant again.
  • The surgery is either performed as a minimally invasive laparoscopy or as a traditional, open surgery.
  • The success rate of pregnancy after tubal ligation reversal generally ranges from 40-85 percent and varies greatly depending on the patient, with age being the largest factor.

What is tubal ligation reversal?

Tubal reversal, also called microsurgical tubal reanastomosis, is an abdominal surgery in which a surgeon reverses a patient’s previous sterilization procedure by reopening and/or reconnecting the fallopian tubes to the uterus. A tubal ligation, or having one’s “tubes tied,” is a popular form of sterilization.

Often times women consider tubal reversal when their life circumstances are altered and they change their mind about getting pregnant. For example, a patient may have had  tubal ligation surgery early and decided later in life that she wanted to have children. Or she may marry someone who hasn’t had children yet and wants her to become pregnant.

Tubal ligation reversal procedure

Depending on the type of surgery, a tubal ligation reversal procedure can either be an inpatient or an outpatient procedure. During this surgery the patient is either administered a general or local anesthetic.

There are also several ways that the tubal ligation reversal procedure can be performed depending on how the patient’s tubes were altered in the first place. Typically in a tubal ligation, surgeons will tie the tubes or clip them shut, burn them closed, or block them.

In order to reverse this, the surgeon performing the tubal ligation reversal surgery will make a small incision to access the uterus, ovaries, and fallopian tubes and utilize small instruments to reconnect the ends of the tubes to the uterus with small stitches or remove any clips or blocking devices. If the tubes are successfully unblocked, it will allow for a sperm to reach the egg and fertilize it. The fertilized egg will then pass through the tubes and attach to the uterine walls, potentially resulting in a pregnancy.

Tubal reversal success rates vary greatly with regard to each patient, though general success rates range from around 40-85 percent. Patients who are considering tubal reversal surgery should be aware that the following factors can affect a patient’s likelihood of a successful pregnancy after the procedure:

  • The patient’s age, as older women are generally less likely to get pregnant after the reversal surgery.
  • The patient’s body mass index (BMI) and overall health level.
  • The type of sterilization procedure that was initially performed to prevent additional pregnancies.
  • The quality of the patient’s eggs as well as the quality of her partner’s or donor’s sperm.
  • The length of the patient’s fallopian tubes and the amount of scar tissue in the pelvic area.

What are the risks of tubal reversal?

Women who get pregnant after tubal ligation reversal are at a greater risk to have an ectopic pregnancy. This occurs when the egg fertilizes and implants outside of the uterus, such as in the fallopian tube. An ectopic pregnancy is a dangerous, often life-threatening condition that will not result in a child, requiring that the pregnancy be ended to protect the mother.

In addition, as with any major surgery, patient’s undergoing tubal reversal surgery are at risk for an adverse reaction to anesthesia, excessive bleeding or damage to other internal organs. Patients who are contemplating a tubal ligation reversal surgery should consider the fact that it is typically a more complicated and risky procedure than the initial ligation surgery.


Alternatives to tubal reversal

An alternative to tubal ligation reversal is in vitro fertilization (IVF) treatment. During IVF a woman’s eggs are removed, are fertilized in a lab by her partner’s or a donor’s sperm, and then the resulting embryo is implanted back into the uterus.

IVF is generally a more expensive alternative than a tubal ligation reversal. Patients should discuss the appropriate option for them with their physician.

 

The Reproductive Science Center of the Bay Area is a leading pioneer in infertility treatments including IVF with egg donation and LGBTQ family building. We’ll work with you to help you achieve your dreams of having a baby.

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