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By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/tubal-ligation-reversal/MY01048
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Definition
A tubal ligation reversal is a procedure to restore fertility after a woman has had a tubal ligation — when the fallopian tubes are cut or blocked to permanently prevent pregnancy.
During a tubal ligation reversal, the blocked segments of the fallopian tubes are reconnected to the remainder of the fallopian tubes, allowing eggs to again move through the tubes and sperm to travel up the fallopian tubes to join an egg.
Sterilization procedures that cause the least amount of damage to the fallopian tubes are the most likely to allow successful tubal ligation reversal. Examples include sterilization with tubal clips or rings. Because of the way the Essure and Adiana systems seal off the fallopian tubes, it's generally not possible to reopen the fallopian tubes after these procedures. In such cases, in vitro fertilization (IVF) may be an option. IVF involves retrieving eggs from the ovary, fertilizing them in a laboratory and implanting them in the uterus.
Why it's done
A tubal ligation reversal can allow a woman who had a tubal ligation to get pregnant without further medical assistance. You may regret having a tubal ligation for many reasons, including:
- Young age at the time of the procedure
- Having the procedure done within a year of giving birth
- A change in marital status
- Having received too little information about tubal ligation or other forms of birth control
- Having the procedure done due to spousal pressure or because of a medical condition
A tubal ligation reversal isn't appropriate for everyone. Your health care provider will consider various factors to determine if tubal ligation reversal is likely to be successful, such as:
- Your age and body mass index
- The type of tubal ligation
- The extent of the damage to your fallopian tubes
- Remaining tubal length
- Other fertility factors, such as sperm and egg quality
A tubal ligation reversal is more likely to be successful if there is still a large proportion of healthy tube. If your fallopian tubes were originally blocked by clips or rings, the tubal ligation reversal is more likely to be successful than if segments of your fallopian tubes were burned in order to close them off (electrocautery). Some types of sterilization, such as the Essure and Adiana systems, are not considered reversible.
Risks
Even if tubal ligation reversal is successful, it doesn't guarantee that you can become pregnant. Pregnancy rates following reversal of tubal ligation vary greatly, from 30 to 85 percent, depending on a woman's age and other factors.
Tubal ligation reversal is abdominal surgery, which carries a risk of infection, bleeding and injury to nearby organs, as well as risks related to anesthesia.
If you do conceive after having a tubal ligation reversal, there's a 2 to 7 percent chance that the pregnancy will be ectopic — when the fertilized egg implants outside the uterus, usually in a fallopian tube.
How you prepare
Before you have a tubal ligation reversal, your health care provider will likely:
- Explain the details of the procedure
- Discuss the likelihood of success and your ability to get pregnant after the procedure
- Discuss other options for pregnancy, such as IVF
What you can expect
A tubal ligation reversal can be done as an inpatient or outpatient procedure. The procedure typically takes one to three hours.
During the procedure
To do a tubal ligation reversal, your doctor will make a small incision in your abdomen (minilaparotomy) and expose your uterus, fallopian tubes and ovaries. Using a microscope as an aid, the doctor will remove blocked fragments of the fallopian tube and attempt to repair the tube with tiny absorbable stitches. Remember, your health care provider may not be able to reattach one or both of your fallopian tubes if too much was removed during the tubal ligation.
After the procedure
It may take a week or more to recover from tubal ligation reversal surgery.
Avoid using aspirin for pain relief after tubal ligation reversal, since it may promote bleeding. You may bathe 48 hours after the procedure, but avoid straining or rubbing the incision for one week. Carefully dry the incision after bathing by patting it with a towel.
Avoid strenuous lifting and sex for two weeks. Resume your normal activities gradually as you begin to feel better. Your stitches will dissolve and won't require removal. Make an appointment to see your health care provider a week after surgery so he or she can make sure you're healing properly.
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- Gallenberg MM (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 19, 2011.
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