Options for Reversing Ligated Tubes

If you've changed your mind after having your tubes tied and want to conceive again, you're likely weighing a tubal reversal versus in vitro fertilization (IVF) treatments. A tubal reversal is actually one of the best kept secrets when it comes to having more children. The chances of conceiving again are much higher than with IVF treatments, and a tubal reversal carries far fewer risks.

According to the Centers for Disease Control, an in vitro fertilization treatment after tubal ligation gives you about a 35 percent chance of getting pregnant. That's for one treatment. If it doesn't work, you'll have to opt for another expensive treatment, until you either run out of money or have success. IVF treatments carry more risk of ovarian problems, ectopic pregnancy, miscarriage and even death in rare cases.

A tubal reversal gives patients about a 70 percent overall chance of getting pregnant--about twice as high as IVF treatments. You have a much higher number of chances to become pregnant, because you'll be relying on intercourse. The risks are also much lower, because you won't be relying on the powerful drugs that are associated with in vitro fertilization. If your doctor insists on IVF treatments after your tubes have been tied, it's worth getting a second opinion to talk with a specialist about tubal reversal.

There are several approaches or types of tubal ligations that can later be reversed, including:

Reversing Tubal Ligation and Resection – The pregnancy success rate for a reversal of this type of tubal ligation is roughly 60-70 percent. This type of tubal ligation is typically done immediately after childbirth, and involves tying off 1-2 centimeters of the fallopian tube, and cutting out the section of tube between the two ligatures.

Reversing the Pomeroy Technique – It is estimated that about two-thirds of women are able to get pregnant after reversal of a Pomeroy tubal ligation. This technique for tubal ligation is very common, and involves tying a loop in the center of the fallopian tubes, and then surgically removing the knotted portion. Next, the ends of the tubes are sealed, and this prevents an egg from traveling to the uterus.

Reversing Tubal Rings or Tubal Clips – It is estimated that two-thirds of women who undergo a reversal of the rings or type of tubal ligation will be able to get pregnant. In this tubal ligation procedure, the surgeon uses a device to crimp or close the tube. Eventually, the part of the tube that is crimped forms scar tissue that prevents an egg from passing to the uterus.

Reversing a Tubal Coagulation – Approximately 40-60 percent of women who undergo reversal of a tubal coagulation will get pregnant, depending on which type of coagulation they had received. This type of tubal ligation uses electricity to cause blood to coagulate in the fallopian tube, creating a barrier that prevents eggs from passing through.

Reversing a Fimbriectomy – The success rate after reversing this type of tubal ligation is a bit lower—roughly 30-40 percent—and this approach is not used as often as the other types. This tubal ligation procedure involves removing the part of the fallopian tubes located directly next to the ovaries.

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