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Tubal Reversals: What to Expect

Some women find they are unhappy with their tubal ligations and want to undo the process later in life so they have a chance to conceive. The most common reasons women have for wanting a tubal reversal are remarriage, loss of a child and having a tubal ligation performed before age 30. Tubal reversals are relatively safe procedures that can provide satisfactory results for many women.

  1. Insurance and Cost

    • Most insurance companies do not cover the cost of the tubal reversal procedure itself, but some may cover pre-operative testing as fertility or tubal infertility testing. Patients should consult their insurance companies before setting a surgical date, as most tubal reversal surgeons will want insurance coverage information up front. Costs for tubal ligations vary. Procedures performed on high-risk patients, such as overweight or older women, will generally cost more. Pre-operative testing to determine the length of the fallopian tubes and assess any potentially serious conditions can cost as much as the surgery itself if there are issues that need treatment prior to surgery.

    Surgery

    • Tubal reversal patients should not take aspirin prior to surgery. Patients should also stop using weight loss drugs and herbal supplements 2 to 4 weeks prior to their surgery date. The week after a menstrual cycle is the best time to perform a tubal reversal to minimize bleeding and enlarged ovaries due to ovulation. The tubal reversal procedure takes about 2 hours and involves a 1 to 3-inch incision below the navel for the surgeon to enter the abdomen and repair the fallopian tubes. Patients will usually stay in the hospital for a few hours after surgery, at which point they are released unless there are complications.

    Recovery

    • Recovery from a tubal reversal is usually fairly quick with minimal pain or complications. Recovery times will vary for individual patients, but most women return to short, non-physical work within 3 to 10 days and longer, non-physical work within 2 to 4 weeks. Some physicians advise tubal reversal patients that they may begin trying to conceive within 2 weeks, but it is usually best to avoid sex until 3 to 6 weeks post-surgery. Full physical activity resumes in 4 to 8 weeks. Follow-up appointments are scheduled as needed.

    Success Rates and Factors

    • Reported success rates of tubal ligations vary widely, and there are many factors that contribute to how likely it is that a woman will get pregnant after the procedure. Women who are under 30, have tubes more than 5 cm in length and who have partners with high sperm counts are the most likely to conceive. Low success rates are common in women with shorter tubes and women older than 43.

    Risks and Complications

    • As with any surgical procedure, there are possible risks and complications of tubal reversal surgeries. Reactions to anesthesia and infections of the surgical site are possible risks of any operation, including tubal reversals. Women who undergo tubal reversals are heavily monitored in the beginning stages of pregnancy because of the increased risk of ectopic pregnancy, a potentially fatal condition where a fertilized egg implants itself outside of the uterus, usually in a fallopian tube.

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