Tubal Ligation Reversal: Process, Risks, Cost And Alternatives

Tubal Ligation Reversal Process, Risks, Cost And Alternatives

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You may have chosen to get your tubes tied, after deciding that you do not want to have any more kids.

But you’re having second thoughts about it now, and want to reverse the surgical sterilization procedure. That’s okay, and possible too with the tubal ligation reversal option.

If you are considering to get the tubes untied to have a baby, read this MomJunction post. Here, we tell you about the procedure for tubal ligation reversal, its cost, timeline, risks, and alternatives.

What Is Tubal Ligation Reversal?

Tubal ligation is done to prevent pregnancy. Reversing the procedure involves untying the tubes to restore fertility (1). During the tubal ligation procedure, the surgeon might cut, tie, or block the fallopian tubes to prevent the movement of eggs through the tubes.

On the other hand, tubal ligation reversal reconnects, unties, or unblocks the fallopian tubes, allowing the eggs to travel through the tubes and meet the sperm for fertilization (2). This gives you a chance to get pregnant naturally.

The procedure of untying the tubes is also called tubal reversal, tubal reanastomosis, microsurgical tubal reanastomosis, and tubal sterilization reversal.

Why Is Tubal Ligation Reversal Done?

Usually, women choose to reverse the tubal ligation procedure if they want to get pregnant again. However, some may go for it due to the post-tubal ligation syndrome that could cause pain in the lower back, pain during intercourse, pre-menstrual problems, the absence of periods or problem menstruating, or uterine hemorrhage (3).

That said, not all women may be able to get a tubal reversal. The procedure is suitable only for women who are fit for surgery.

Can You Have Tubal Reversal Surgery?

The success rate if tubal reversal is good, but you have to check if the procedure is safe for you.

  1. Age of the patient: To undergo the tubal reversal surgery, the woman should be under 40 years of age (4).
  1. Body mass index: The patient’s BMI should be less than 27 kg/m2.
  1. The technique used for tubal ligation surgery: Not all methods of tubal ligation can be reversed. Usually, a procedure that uses rings and clips can be reversed successfully. In case the tubes were burnt, then it cannot be reversed (5).
  1. Time passed since previous surgery: The doctors will check how much time has passed since the tubal ligation surgery. If it was done not quite long ago, then the reversal procedure will most probably work.
  1. The condition of the fallopian tubes: If the tubes are completely damaged, it is not possible to reverse the tubal surgery. Besides the health, the length of the remaining part of the tubes is also examined by the doctors.
  1. Others: These include the fertility results of the partners, menstrual cycle, ovarian reserve testing, and your medical history (6).

If you meet the above requirements, doctors would check your present health condition and recommend the tubal reversal surgery.

What Is Done Before The Surgery?

Discuss these points with the doctor before deciding on the surgery:

  1. Tell your doctor why you are seeking a reverse surgery.
  1. If you smoke or drink, stop it until after the surgery.
  1. In case you are taking any medications, supplements, or herbs, tell your doctor about it. You may have to discontinue them until the surgery.
  1. Ask about the tubal ligation reverse procedure, what could be the success rate in your case, how it would be done, and anything else you want to know about it.

If the discussion is fruitful and you are sure about it, you can go ahead with the procedure. Keep reading to know how it is done.

How Is Tubal Reversal Done?

The procedure is performed in two to three hours when the patient is under general anesthesia. It is a minimally-invasive procedure with 70 to 80% chances of success (7).

To view the fallopian tubes, a laparoscopy is performed by inserting a tiny telescope into the abdomen. Based on the findings, a small incision is made to begin the surgery. Advanced micro-surgical tools are used by the surgeon to remove or repair the damaged parts of the fallopian tube, which is then reconnected using fine, absorbable sutures. Finally, the doctor will use magnifying lenses to locate and remove any remaining scar tissue (6).

This method ensures that the path in the fallopian tube is cleared for the eggs to move, thereby increasing your chances of getting pregnant. To check if the surgery was successful, the doctors will inject a blue dye into the tubes. No leak from the tubes would mean the surgery was successful.

Recovery After A Tubal Reversal:

Ideally, you should be discharged the same day or the next day in some cases. Typically, it takes a week or two to recover after the procedure. Some women may need three to four weeks too.

Your doctor will give you post-operative instructions such as when to proceed with normal activities, when to take a bath, and may prescribe oral medications as well. Visit your doctor within a week of the surgery for a check-up, to know if your body is healing well.

What Are The Chances Of Getting Pregnant After Reversal?

Around 50 to 80% of the women could have a normal pregnancy after tubal ligation reversal surgery (8). Most women get pregnant within a year or two after this procedure. However, certain factors that determine the success of pregnancy after the surgery.

  1. Age of the woman: If the woman is under 40, the chances of intrauterine pregnancy are almost 90%. For women aged over 40, the cumulative success rate is around 40-70% (2).
  1. Scar tissue: If there is any scar tissue from the previous surgery, it could reduce the chances of successful pregnancies. Therefore, the doctors make sure it is removed while they are performing the procedure.
  1. The condition of the fallopian tube: When there is minimal or no damage to the Fallopian tubes, the success rate of pregnancy is high.
  1. Fertility quality: When you and your partner have no infertility issues, then you can get pregnant soon. Your partner’s sperm quality can also be tested to evaluate the chances.

Next, we tell you about the possible risks and complications of this procedure.

Risks And Complications

Yes, there could be some complications due to the reversal procedure (9):

  1. There is a risk of injury to a blood vessel, bladder, or bowel during the surgery.
  1. Risks associated with general anesthesia.
  1. Although rare, ectopic pregnancy or implantation of the egg outside the uterus could be a major risk for the mother.

The procedure may allow you to get pregnant, but it also costs you a bit.

How Much Does Tubal Reversal Surgery Cost?

The cost of reversal surgery varies from one city to another in the US. However, it could range in between $1,000 and $21,000 (10). The patients should know that insurance might not cover the surgery cost.

What Are The Alternatives To Tubal Reversal Surgery?

In vitro fertilization or IVF is an alternative to tubal reversal to get pregnant. It is a common procedure that could be done even if the fallopian tubes are damaged. Here, the fertilization of eggs with the sperm is done in a laboratory, and then the fertilized eggs are implanted in the woman’s uterus.

Even women above 40 years of age who have had an unsuccessful tubal reversal could get pregnant with IVF. However, only your doctor could confirm if it is possible for you, based on your medical history (11).

While tubal ligation reversal is safe and effective, it is essential that you discuss with your doctor the possibility of its success and your chances of getting pregnant. The procedure does have its risks and also costs money, something you should keep in mind when deciding whether or not to go for it.

Did you or anyone you know try tubal ligation reversal surgery? Share your experiences with us in the comment section.

References:

1. What Is Tubal Ligation Reversal Procedure?; New York Fertility Institute
2. Tubal ligation reversal; University of Arkansas for Medical Sciences
3. K. Satoh and H. Osada; Post-tubal ligation syndrome; Nihon University School of Medicine (1993)
4. Tubal reversal; Wake Forest Baptist Health
5. Female Sterilization (Tubal Ligation); Health Guides: Center For Young Women’s Health (2017)
6. Tubal ligation reversal: Obstetrics & Gynaecology; University of Illinois Hospital
7. Tubal ligation reversal; Michigan Medicine: University of Michigan
8. Tubal Ligation; URMC
9. Tubal ligation reversal or tubal reanastomosis; University of Utah Health Hospitals and Clinics
10. L. B. Messinger et al.; Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation; American Society for Reproductive Medicine (2015)
11. D. Sitko et al.; IVF following impossible or failed surgical reversal of tubal sterilization; Human reproduction (2001)

 

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