Is Tubal Sterilization Reversible?

Reviewed on 11/3/2020

Is tubal sterilization reversible?

Tubal sterilization may be reversible, depending on how the original procedure was done.
Tubal sterilization may be reversible, depending on how the original procedure was done.

Tubal ligation is technically reversible. However, the procedure is complicated and the results are not guaranteed. Though it is possible to reverse a tubal ligation, it is a major surgery that doesn’t always work, it is rarely covered by insurance and it is not recommended. The success rate of tubal sterilization reversal depends on the method used for tubal ligation and how much of the fallopian tube is damaged after tubal ligation. Women who have had a tubal ligation reversed have a higher than average risk of a fertilized egg implanting in the fallopian tube (ectopic pregnancy) rather than in the uterus. This can become a life-threatening emergency.

Other considerations about having a tubal ligation reversed include the following

  • The surgery takes several hours and most women are hospitalized for at least 2 days.
  • There is no guarantee that the patient will be able to become pregnant after having the reversal.
  • Surgeons usually refuse to perform the surgery if they think there is little chance that it will be successful.
  • About half of the women who request reversal are turned down.

How is tubal sterilization reversal performed?

Before the procedure, the doctor will likely suggest getting a complete physical exam. The exam may include blood and imaging tests to make sure the ovaries are normal. A hysterosalpingogram (HSG) may be done to check the length and function of the remaining fallopian tubes. The doctor may also suggest some tests for the woman’s partner, such as a sperm count and semen analysis, to rule out any fertility problems. If it turns out that tubal ligation may be reversed, the doctor specifies a date.

The procedure is usually done under general anesthesia and takes about 2 to 3 hours. The patient’s vitals are monitored throughout the procedure.

  • The surgeon then makes two small cuts on the belly and cuts out the sealed portion of the fallopian tubes and reattaches the ends carefully with very fine dissolvable surgical sutures.
  • In a few conditions, the surgeon places a small lighted scope, called a laparoscope, through the incisions of the belly button and into the pelvic area. This lets the doctor look at the fallopian tubes and decide if reversal surgery is possible.
  • If the doctor decides it’s okay to do the reversal, they may then make a small surgical cut called a "bikini cut" near the pubic hairline.
  • Microscopic instruments attached to the end of the laparoscope let the doctor remove any clips or rings that were used to block tubes and reconnect the ends of the tubes to the uterus using very small stitches.
  • The cuts are closed and the patient may be monitored closely.
  • Patients usually require at least 15 to 30 days to recover after the procedure depending on their age. During the healing process, the patient may be placed on painkillers, antibiotics and vitamin supplements.

All surgery has some risk. The complications of tubal ligation reversal include

What are the chances of getting pregnant after a tubal sterilization reversal procedure?

The chances of getting pregnant after a tubal ligation reversal varies from woman to woman. The patient’s health and age are prominent factors, which are taken into consideration before recommending surgery. In general, a reversal of tubal ligation is successful 40% to 85% of the time. Most women with a successful reversal get pregnant within the first year.

What are the alternatives to a tubal sterilization reversal procedure?

In vitro fertilization (IVF) is an alternative to tubal sterilization reversal. In this procedure, the egg and sperm are fertilized outside the womb in a laboratory dish. The fertilized egg (embryo) is later placed into the patient’s womb. IVF is also an option if a patient doesn’t get pregnant after tubal ligation reversal surgery. Surrogacy may also be considered.

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References
Medscape Medical Reference

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