Overview

Tubal Ligation Reversal or Tubal Reanastomosis

Tubal Ligation Reversal or Tubal Reanastomosis

Sometimes women who’ve had tubal ligation (also called having your tubes tied) decide that they would like to reverse the procedure so they can have children again. Our center has more than 30 years of experience counseling women about this procedure and performing ligation reversal for women where it’s the best fertility option.

Fallopian Tubes & Tubal Ligation

The fallopian tubes are delicate, flexible muscular structures. Sterilization procedures remove or destroy a portion of the tube, usually in the middle. To reverse sterilization procedures, your doctor will need to carefully reattach portions of the tube that haven’t been destroyed.

Whether tubal ligation reversal is successful depends on how much fallopian tube a woman has left and which portion of her tube needs to be repaired. It’s better when woman have more fallopian tube left. Tubal ligation reversal is a delicate surgery that requires special equipment. Your surgeon who performs the reversal should have a lot of experience with this type of surgery.

At UCRM, we use a mini-laparotomy approach to perform tubal ligation reversal (also known as tubal reanastomosis). A mini-laparotomy is the most studied and effective way to reverse tubal ligation. All of our patients have this procedure done as a same day surgery. You will not need to stay in the hospital to recover.

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Initial Consultation Before Surgery

If you are considering tubal reanatomosis, we will ask you to make an initial consultation with one of our specialists. At this appointment, your specialist will review your medical history, fertility history, and the report of your tubal ligation surgery. Sometimes we may need additional evaluations about your fertility. It will be especially important for us to see the post-op report from your tubal ligation surgery. This report will help us give you accurate counseling and planning.

After we review your information, we will give you an individual assessment about your chances of having a successful surgery. If you would like to have tubal ligation reversal, we will need these things:

  • Your male partner must have normal fertility,
  • your menstrual cycles must be normal,
  • your uterus must be able to support a pregnancy, and
  • you must provide evidence that your fallopian tubes can be repaired. We will need records from your tubal ligation surgery.

We also require women to attend consultation appointments so they can be fully informed and consent to the procedure.

We do not recommend the surgery for women older than 44 years of age.

How Is Tubal Ligation Reversal Performed?

Tubal ligation reversal is a same day surgery performed under general anesthesia. We may start with a laparoscopic viewing of your tubes to determine whether the surgery can be done. A laparoscopy will help us see how much of your fallopian tubes can be repaired. To do the laparoscopy, your surgeon will insert a small telescope through your belly wall.

If laparoscopy findings are favorable, or if we determine that you don’t need a laparoscopy, we will start the surgery. To perform the reversal, your surgeon will make a small horizontal incision (a cut that’s one to three inches) very low on your abdomen.

After your surgeon finds your fallopian tubes, your surgeon will remove the damaged portions of your tubes along with any devices used during the original sterilization like clips, rings, or sutures. Your surgeon will then reattach the separated portions of your tubes under a microscope. Your surgeon will use special tools that are specifically designed to minimize damage to your fallopian tubes and internal organs.

Your surgeon will use two layers of very fine sutures (stitches) to reconnect your fallopian tubes. These stitches are finer than most human hair. By using microscopic magnification, fine instruments, and sutures, an experienced team of surgeons can reduce scar tissue. Reducing the amount of scar tissue inside your fallopian tubes increases your chances of getting pregnant.

How Long Does Tubal Ligation Reversal Take?

The procedure usually takes two to three hours. During the procedure, your surgeon will inject blue dye into your fallopian. If no dye leaks from the end of your tubes, this means that your tubes have been reattached successfully.

After Surgery/Recovery

Patients usually can go home three to four hours after the surgery. Most women will need to wait two to three weeks before they can return to their full and normal activities.  You may become easily tired for another week or two.

Complications

We ask patients traveling from out of state to stay in the Salt Lake City area for two to three days before returning home. Postoperative complications are very rare because this procedure is minimally invasive. Possible complications include:

  • infection,
  • unintended bleeding, and
  • clots.

Your specialist will tell you what symptoms to look for if there are complications, although these complications are very rare.

Success Rates For Tubal Reanastomosis

The success rate of the mini laparotomy tubal reversal depends on several factors:

  • Other factors that can reduce fertility such as low sperm count or severe problems with menstrual cycle.
  • The type of tubal ligation: Your chances of having a successful pregnancy will be higher if less damage was done to your fallopian tubes when you had your tubes tied. Women have less damage to their tubes if their doctor used clips or rings to tie their tubes.
  • Women who are over 40 may have a harder time getting pregnant.

About two-thirds of women who have tubal ligation reversal become pregnant. However, your chances of becoming pregnant will depend on your age, other fertility factors, and how much your fallopian tubes were damaged when you had your tubes tied.

If you have a tubal ligation reversal, your chances of having a miscarriage won’t increase. But your chances of having an ectopic (tubal) pregnancy will be higher after you have a tubal ligation reversal. One in ten women who get pregnant after getting their tubes untied will have an ectopic pregnancy. We recommend that doctors carefully watch early pregnancies for women who have this procedure.

Having a tubal ligation reversal won’t affect your pregnancy, labor, or delivery. The table below lists the chances of getting pregnant 18 months after the surgery for women of different ages:

Pregnancy Rates After Tubal Ligation Reversal

Less than 36 years old: 70-80 percent

36 - 39 years old: 60-70 percent

40 - 43 years old: 30-40 percent

Gordts S, Campo R, Puttemans P, Gordts S. Clinical factors determining pregnancy outcome after microsurgical tubal reanastomosis. Fertil Steril. 2009 Oct;92(4):1198-202.

Tubal Ligation Reversal vs. IVF: Which Is Better?

Not all women are a good candidate for tubal ligation reversal. For some women, IVF is a better option and will increase your chances of having a successful pregnancy. Your fertility specialist will consider the following factors to help you make a decision between tubal ligation reversal and IVF:

  • your age
  • how many children you want
  • health factors that will make a tubal ligation reversal more risky
  • the type of sterilization you had
  • cost
  • your attitudes about surgery vs. assisted reproductive procedures (IVF)
  • other fertility factors like your partner’s sperm count and your menstrual cycle

How Much Does It Cost to Have a Tubal Ligation Reversal?

The total cost of the procedure is $6,600.00* when it’s performed at University of Utah Health’s facilities (these fees include using a UCRM surgeon and anesthesiologist).

*Prices are subject to change without notice and may also be subject to additional pharmacy charges.