Are You a Candidate for Tubal Reversal?

Are you considering a tubal reversal, or reversal of your tubal ligation? Tubal ligation or "having your tubes tied" is a popular choice of permanent birth control. During this surgery, the fallopian tubes are cut or otherwise blocked to prevent an egg from being sterilized by sperm. With the tubal ligation procedure, a woman is instantly rendered sterile.

That said, sometimes a woman changes her mind and wants to have another child after having had a tubal ligation. The surgery to reverse the sterilization is called tubal ligation reversal, reanastomosis or tubal reversal.

Tubal Ligation by the Numbers

Clearly, this is a popular method of birth control. Look at the numbers:

  • In the United States, there are 700,000 tubal ligations performed annually. Considered a permanent form of birth control, the surgery is 99 percent effective in preventing pregnancy.
  • Overall, there are 11 million women in the U.S., ages 15 to 44 years old, who have chosen to undergo a tubal ligation in the past.
  • Going global, there are 190 million couples that have opted to use tubal ligation as a permanent form of birth control.

Now I Want to Reverse It!

According to recent statistics, about 6 percent of women who have a tubal ligation later change their minds and want to become pregnant again--within five years of the original surgery. Women under age 30 are the most likely to regret having their tubes tied.

A reversal can be done but is a tedious surgical process that reattaches the fallopian tubes.

Why Do Women Change Their Minds?

There are many personal reasons why a woman decides to reverse a tubal ligation. Some of the most common reasons for tubal reversal include:

  • Simply changing her mind about having more children
  • A late/unexpected marriage
  • A second marriage and the wish to have a child with new spouse; this is typically the most common reason to have a tubal ligation reversal
  • Having been persuaded to have a tubal ligation too young or while having marital problems
  • The loss of a child sometimes leads to the wish to have another; this is a rare scenario

Criteria to be a Successful Candidate

Some women have a better chance of achieving pregnancy after the surgery for the following reasons:

  • Only a small portion of fallopian tubes removed during surgery; need at least 1” of tube coming out of uterus and 2 ½” or more of remaining tube with normal fimbriae or ends of the tubes
  • Rings or clips originally used to close tubes
  • Younger than age 40
  • Had original surgery done immediately after childbirth
  • The shortest period of time lapse between the original surgery and the reversal
  • Overall reproductive system health including ovaries, uterus and remaining fallopian tubes

Who is Not a Good Candidate?

Some women are less likely to have a successful reversal and not become pregnant for some of the following reasons:

  • Advancing age
  • Length of time since the original surgery
  • The technique used for the tubal ligation; cautery (burning), clips or rings
  • If tubes were tied close to the site where they attach to the uterus or at the end where the tube is larger, there is a lower success rate; tubes are usually tied in the middle section
  • Other health issues like endometriosis or fibroid tumors

Outcome of Tubal Reversal Surgery

There is a 30 to 85 percent variation in the success rate of tubal reversal surgery. The average chance of conceiving by natural means after a tubal reversal is 75 percent. Most pregnancies occur in the first year after having a tubal reversal.

A frank discussion with a qualified gynecologist will help to determine the chance of a successful tubal reversal as well as a woman’s other options for conception.

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