Tubal Ligation Reversal

Tubal ligation reversal overview

  • Women who undergo a tubal ligation (female sterilization) may change their mind and desire the ability to get pregnant.
  • Tubal ligation reversal is a surgery to untie, reconnect or reopen a woman’s fallopian tubes to allow for pregnancy.
  • Tubal ligation reversal is generally a minimally invasive abdominal surgery with up to two weeks of recovery time.
  • Pregnancy rates after a tubal ligation reversal range from 30-87 percent, depending on the woman’s age and the type of tubal ligation surgery she had.

What is tubal ligation reversal?

Tubal ligation reversal surgery, commonly referred to as a tubal reversal, involves untying, resecting or reopening the fallopian tubes of a woman who has previously undergone a tubal ligation surgery. Tubal ligation is a self-determined form of female sterilization surgery that blocks the fallopian tubes so eggs from the woman’s ovaries cannot enter the uterus and sperm cannot reach the egg to fertilize it.

Many women choose to get their “tubes tied” with a tubal ligation because they have decided not to have any more children. This decision could cause regret later in life due to a remarriage, death of a loved one or a simple desire for more children.

Prior to a tubal reversal, a woman will need a physical exam in order to determine if she is a good candidate for a reversal. During surgery, the doctor will insert a laparoscope with a light and camera through an incision in the belly button in order to better see the fallopian tubes.

The doctor will then make a small cut near the bikini line and remove any clips or rings that were previously used to clamp the fallopian tubes closed. The surgeon then reattaches the fallopian tubes to the uterus (if necessary). If successful, tubal reversal opens the tubes to allow an egg to travel to the uterus during ovulation.

Recovery time for a tubal reversal is approximately two weeks. Most women can return to work within two to four days of surgery. The doctor will prescribe painkillers to ease discomfort during recovery and the incision site will need to be watched for irritation or infection.

Who should consider tubal ligation reversal?

Many women feel pressured by a partner or loved one to get their tubes tied for financial or lifestyle reasons. The conversation of a tubal reversal usually happens when a woman is with a new partner who does not have any children of his own.

Sometimes, a couple might experience the loss of a child after a tubal ligation and may want to explore the possibility of having another baby.

Whatever the case, the decision to undergo a tubal reversal is a personal one and should be discussed with a reproductive surgical specialist.

IVF as an alternative to tubal ligation reversal

The fertility doctors at LLU Center for Fertility work one-on-one with patients to help them determine which course of treatment is right for them. Women who have had tubal ligation have two options for achieving a pregnancy: tubal reversal or in vitro fertilization (IVF). The doctors review each patient’s medical history and conduct a physical exam to determine which course of treatment will give the patient the best chance of getting pregnant.

The success of a tubal reversal depends on many factors, including if the woman still has a large healthy portion of her fallopian tubes remaining after the tubal ligation. Some forms of tubal ligation do not leave enough of the fallopian tubes and are therefore not reversible.

IVF can be the best course of treatment for achieving a pregnancy after having one’s tubes tied. Unlike tubal reversal, IVF patients don’t have the recovery time associated with surgery.

Interested in learning which options are right for you? Request an appointment today.

What are the risks of tubal ligation reversal?

Tubal ligation reversal is considered a major abdominal surgery and carries with it all the risks of surgery, including bleeding, damage, infection and a reaction to anesthesia.

Women who become pregnant after a tubal reversal have a higher chance of ectopic pregnancy, which involves the embryo implanting somewhere outside the uterus. Ectopic pregnancy can be life threatening to the mother. Because a baby cannot survive anywhere but the uterus, an ectopic pregnancy typically ends in a miscarriage.

A tubal reversal may also cause additional scar tissue to form, keeping the fallopian tubes blocked. In this case, IVF can help achieve pregnancy. IVF is the process of removing a woman’s eggs from her ovaries and fertilizing the eggs with her partner’s sperm in a lab. The fertilized embryos are then implanted directly into the woman’s uterus, thus eliminating the need for working fallopian tubes.

What are the benefits of tubal ligation reversal?

Tubal ligation reversal surgery gives women and couples who have changed their minds about wanting more children the chance to conceive through sexual intercourse or intrauterine insemination (IUI). IUI may be recommended after a tubal ligation in order to give the sperm the best chance at fertilizing the egg.

Pregnancy rates after reversal

Age and tubal ligation method are the two main factors that influence pregnancy rates after tubal reversal surgery. Women under the age of 30 who had a ligation using a ring or clip method have the best chance for achieving pregnancy (about 87 percent).

The lowest pregnancy rates (about 30 percent) are often found in women over the age of 40 who had a ligation by removing the end of the fallopian tube.

Tube length may also affect pregnancy rates after reversal. Fallopian tubes, prior to tubal ligation, are typically 10-12 cm in length. After a tubal ligation surgery, women with at least 7.5 cm of tube at the time of ligation reversal have an 80 percent chance of achieving pregnancy.