My tubes have been tied for 20 years. Can I get a tubal reversal? If so, what are my chances of becoming pregnant?

Thank you for the email. There are many things to consider when deciding if a tubal reversal is the right choice for you and your family.

The obvious advantage with a tubal reversal is the hope that you will be able to achieve pregnancy with no interventions. The typical estimate is that, if everything goes well and all things are optimal, about 75% of women will achieve pregnancy within their 1st year of trying. If there are any factors that are not optimal, the chances for success can be significantly lower.

Here are some things to consider:

• Before a tubal reversal should take place, we first need to know if it is a good option. For example, we need to think about egg quality, your age, tubal status, endocrine status, and it is very important to know what the sperm quality is of the male partner.

• If you are determined to be a good candidate, surgery will need to take place. The success of the surgery often can not be determined until after the surgery. For example, what conditions are the tubes in and is there any scar tissue or endometriosis.

• The surgery typically requires 6-8 weeks of leave from work due to the open incision.

• If the reversal is “successful," the chance of success is still not ensured. For example, there is an increased risk for ectopic pregnancy.

• After a reversal, you will also have to once again consider birth control options (contraception vs. another tubal ligation)

The other option is obviously IVF. The benefits of IVF are:

• Many variables can be worked around
• Success rate each month is much greater
• Options for prevention of genetic disease through new genetic screening
• Option to screen embryos for chromosome or genetic conditions to decrease the chance for having a baby with a syndrome, or a miscarriage, through a process called preimplantation genetic testing.

There are obviously drawbacks as well:

• Requires medication for stimulation
• It is not the “natural” option that some couples desire
• Cost may be a burden for some couples

There is much to consider prior to deciding what is the best option. The first step is a consultation with a fertility specialist to discuss your history and to start your lab work up. From there, the specialist will be able to advise you on the options that best fit your needs.

Published on Jul 11, 2012

You would have to get a copy of the procedure that states how the tubes were tied to see if the tubal can be reversed.

Published on Jul 11, 2012

Under most circumstances, the tubal ligation is reversible. Many experienced surgeons will review the surgical notes from your ligation and give their opinion. If the notes are not available, the surgeon will review the circumstances of the ligation and will be able to comment about the possibility of reversibility even without the surgical notes based on how surgeries are usually carried out in this country. Your age will be the most important issue limiting your chance of pregnancy.

Published on Jul 11, 2012

The length of time since your tubal ligation is not that important unless it makes you older than the age of 42. Tubal reversal is possible if your tubes have been tied for 20 years.

Published on Jul 11, 2012