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Procedure for Tubal Ligation Reversal

Women who think they don't want any more children often have a tubal ligation--in common parlance, having your tubes tied. But life situations can change, and sometimes women who've had such a procedure later decide they do, in fact, want to get pregnant. There are two routes they can take: a reversal of the tubal ligation surgery or in vitro fertilization. Following sterilization by tubal ligation, reversal is most typically the cheapest and most effective choice for getting pregnant.

  1. Considerations

    • You first need to decide whether tubal reversal surgery is the right option for you. In general terms, the numbers often support it: the costs are, on average, $5,900 and pregnancy rates are about 75 percent. That compares with $8,000 for a in vitro fertilization cycle, which has a pregnancy rate of about 27 percent.

    Examination

    • To see if the surgery will actually work for you, it's good for your doctor to examine the operative report from your original procedure. That way the doctor knows exactly what a reversal would entail--and also how much it should cost and the likelihood of success--in your particular case. If the original report can't be obtained, the doctor can perform what's known as a diagnostic laparoscopy at the beginning of surgery to check out your fallopian tubes and see if a tubal reversal has a good chance of working. If it looks like a "go," the surgeon will fix the tubes on the spot. Otherwise, the procedure will be ended and many doctors will then partially refund your money.

    Procedure

    • In reversal of tubal ligation, the surgeon opens and rejoins what's left of the fallopian tubes following the original ligation surgery. Generally, the surgeon is working with two segments that have been separated. The section that runs from the uterus is called the proximal tube segment, and the one that leads to the fimbria, adjacent to the ovary, is called the distal tube segment. Exactly how the surgeon will go about the procedure will depend on how the tubal ligation was originally performed. There are several tubal ligation methods, including various permutations of clipping, banding, cutting and burning the tubes.

    Recovery

    • Many experienced surgeons can perform a tubal ligation reversal through an incision of only 2 to 3 inches, minimizing pain and recovery time.The reversal may cause less discomfort than the original ligation procedure. Once the tubes are rejoined, doctors will perform a dye test to ensure they're open. It's very typical for the procedure to be performed with general anesthesia.

    Follow-up

    • You should be able to go home as soon as an hour after the procedure is done, but you'll need someone with you to drive because you'll still be groggy. You'll probably need to be seen the next morning for a check-up, but you should be able to get back to work within days. The doctor who performed your tubal ligation reversal will probably want to see you regularly. Immediately after surgery, you should begin taking a folic acid supplement, which a developing fetus will need should you get pregnant. Your doctor will want to know at once if you turn up with a positive pregnancy test. Though it's still rare, a tubal pregnancy--a potentially dangerous condition--is more likely in women who've had reversal of tubal ligation.

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