What is a tubal reversal?
Tubal ligation (or "tying the tubes") is surgery to close a woman's fallopian tubes. These tubes connect the ovaries to the uterus. A woman who has this surgery can no longer become pregnant. Over 650,000 women each year chose to be sterilized and tubal ligation is a popular procedure to achieve sterilization. Tubal ligation is considered a permanent form of birth control, and not recommended as a short-term method or one to be reversed. Even so, major surgery can sometimes reverse it. As much as twenty-five percent of women who have undergone tubal ligation choose to have it reversed it at some point in their lives.
Who should consider a tubal reversal?
In order to determine whether a woman who has had tubal ligation surgery is a candidate for reversal, an assessment by a fertility specialist is needed. The assessment will involve a physician examining the fallopian tubes with a laparoscope to see how the surgery was originally performed.
The following factors will determine whether or not a woman is a good candidate for tubal ligation reversal:
- Whether the fallopian tubes were blocked or surgically cut in the initial tubal ligation surgery
- How much of the fallopian tubes remain intact for reattachment
- The overall health of the fallopian tube
- The age and general health of the woman
How is Tubal Ligation Reversal performed?
Tubal ligation reversal is a major surgery usually done in a hospital under a general anesthetic. During surgery, the physician will open and reconnect the woman’s fallopian tubes either by removing clamps, clips, rings or rubber bands used to close them off, or by removing existing blockages in the tubes. The procedure typically lasts about 2 hours.
An overnight stay in the hospital is usually required following the surgery. In some cases longer hospital stays are required, depending upon the woman’s rate of recovery. Full recovery time varies for each individual and is normally between two and four weeks.
Tubal ligation reversals using microsurgical techniques are now offered in many clinics around the country. Reversals done with this technique are able to reattach fallopian tubes with fewer incisions and faster recovery times. In addition, they can be done in an outpatient clinic setting, rather than in a hospital.
There are two types of microsurgical procedures used to reverse a tubal ligation. Microsurgical tubal anastomosis uses a narrow stent threaded through the opening in the fallopian tube and reconnects the tube to the uterus. Sutures are used to correctly align and secure the fallopian tube in place. If a woman has undergone a monopolar tubal coagulation surgery, there is no longer an opening in the uterine cavity for the fallopian tube. In this case, microsurgical tubal implantation is utilized. A new opening is made during surgery for insertion of the fallopian tube.
What are the risks?
While tubal ligation reversal surgery is a fairly common and safe procedure, complications are possible and may include:
- Internal or external bleeding
- Infection at the incision site
- Damage or infection in the surrounding organs
- Allergic reactions to anesthetic
- Increased risk of ectopic pregnancy
What are the results?
The rate of success is dependent upon the woman’s age and how the original tubal ligation was performed. Pregnancy rates for women who have had tubal ligation reversal and are under the age of 40 can range between 20 and 80 percent. Success rates among women who have had the procedure done via microsurgery are even higher, with approximately 80 percent becoming pregnant.
What is the cost?
The cost of tubal ligation reversal varies dependent on the procedure. Costs can range from $5,900 to $ 15,000.