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Reproductive Endo/Infertility
Missouri Center for Reproductive Medicine and Fertility
Tubal Reversal


Introduction:
Tubal ligation is one of the most commonly performed operations in women in the United States. If you have had a tubal ligation in the past and currently desire to have more children, you could be a candidate for a microsurgical tubal reversal (also called microsurgical tubal anastomosis). More than 1% of surgically sterilized women ultimately seek restoration of their fertility.

What is a tubal reversal?
A tubal reversal is a surgical procedure during which the segment of the tube that has been tied is removed and the remaining 2 segments are attached together with the aid of an operating microscope.

Are both tubes "untied" during a tubal reversal?
Yes. More often than not, your doctor is able to reverse the ligation on both your right and left tubes. Occasionally, one side may be heavily scarred from the previous tubal surgery you have had and therefore only the other side is amenable for a tubal reversal. Very rarely are both sides heavily scarred and the operation cannot be performed.

If both sides are heavily scarred, does it mean I cannot get pregnant?
No. You can always undergo in vitro fertilization and therefore "bypass" the tied tubes.

How successful is a tubal reversal?
Depending on which method your tubes were tied, the success of microsurgical tubal reversal is anywhere from 60 percent to 80 percent. Your chances are higher if the remaining total length of the tube after it has been surgically put back together is more than four centimeters (a little less than two inches). Most patients who get pregnant after microsurgical tubal reversal do so in the first 6 months following the surgery, although some patients may take longer to conceive. If only one tube is successfully untied, your odds of getting pregnant are not decreased, but the time to get pregnant may be longer.

How is the surgery performed?
The surgery is performed in one of 2 methods. The classical method involves a small "bikini line incision", about 5 centimeters in length (or 2 inches). You will need to stay overnight in the hospital and will most likely be discharged the next day. The other method is done laparoscopically, and it involves 4 very small incisions (half a centimeter each). You are typically discharged home the same day of your surgery. Ask your doctor which method suites you best.

Is the tubal reversal surgery good for one pregnancy only?
No. Once your tubes are successfully untied, you are able to get pregnant as many times as you need to. However, it is important to remember that if you desire to have only one child, you will need to use some form of contraception after you deliver.

Related Pages
Causes of Infertility
Infertility Evaluation
Ovulation Disorder and PCOS
Male Factor
Pelvic Factor
Unexplained Infertility
Tubal Reversal




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