Tubal Ligation Reversal

Tubal Ligation Reversal

For many women, having a tubal ligation (also known as female sterilization or getting your "tubes tied") is a permanent way to manage your family size. Usually done once a woman feels that her family is complete, as much as 25% of women who have had the procedure end up changing their minds. If you have had your tubes tied but now regret your decision, you may want to consider having a tubal ligation reversal.

Tubal Reversal Surgery
Just as a tubal ligation is considered to be major surgery, so is a tubal reversal. Normally, this procedure takes two to three hours and is done under general anesthetic. In order to make your fallopian tubes functional again, the doctor will unclamp; reattach; remove any devices that may be blocking your tubes or place an implant into your fallopian tubes. This type of surgery does require a hospital stay of at least one night but you may need to remain in the hospital for as much as five days after the surgery. Once you leave the hospital, you can expect to completely recover from the procedure over the course of the next four to six weeks.

As with any type of major surgery, complications are always a possibility. Although they are rare, side effects of tubal ligation reversal surgery may include:

• Bleeding
• Infections
• Damage to the surrounding organs
• Complications due to anesthetic

Thanks to the advances made in microsurgery, though, it is possible for tubal reversals to be done in less than an hour on an outpatient basis. Additionally, only local anesthesia is necessary for this procedure. While this type of surgery is far less invasive than the traditional tubal ligation reversal surgery, thereby significantly reducing the risk of complications, the technology is still new and not widely practiced.

Are There Other Options?
Understandably, many women may think twice about having a tubal ligation reversal. Some women may consider having in vitro fertilization (IVF) instead of "untying" their tubes. Although this can seem like an easier option, it is important to note that undergoing IVF can also be quite taxing on your system.

IVF requires you to take hormonal medications in order to stimulate your egg follicles and help you produce several mature eggs instead of your usual one. Just before your eggs are naturally released, your fertility specialist will retrieve the mature eggs and combine them with a semen sample from your partner. Any fertilized eggs will then be left to develop for a few days before being transferred back to your uterus. The entire process, from beginning the medications to embryo transfer, can take anywhere from four to six weeks. On average, 35% of women undergoing IVF are able to conceive while 29% of women will have a live birth.

Am I a Candidate for Tubal Reversal?
Not all women who have had a tubal ligation will be able to have the procedure reversed. During your initial assessment for the procedure, your fertility specialist will examine the current health of your fallopian tubes, most likely through laparoscopy. She will also look over the surgery and pathology reports from when you originally had the procedure done. Your specialist will also consider the following factors:

• How your tubal ligation was done (whether your fallopian tubes were cut, tied, cauterized or non-surgically blocked)
• At what point in your fallopian tubes the sterilization took place
• Just how much of your fallopian tube is left
• How healthy your fallopian tubes are
• Your age

Will I Get Pregnant?
Although pregnancy rates after a tubal reversal are significantly better than trying to conceive through IVF, having the procedure done does not guarantee that you will become pregnant.

Women under the age of 40 who have a tubal reversal through the traditional surgical methods have a 70% to 80% pregnancy success rate, with conception usually occurring during the first year after the procedure. Women who have microsurgery done have a slightly higher success rate, with about 90% of women becoming pregnant within one year of the procedure. However, tubal ligation success rates tend to decline with a woman’s age although they are still better than IVF pregnancy rates.

It is important to note, though, that having a tubal reversal does increase your risk of experiencing an ectopic pregnancy. Among the general population, about 1 in 100 women will experience an ectopic pregnancy. However, for women who have had a tubal reversal, this risk increases to about 5 in 100 women.

If you suspect that you are pregnant, make an appointment with your health care provider right away to ensure that you and your baby are healthy.