Tubaligation, commonly known as having one's tubes tied, is considered a permanent form of female sterilization. However, there are several reversal tubal ligation surgeries available for women who change their minds. Reversal tubal ligation procedures are the ideal treatment option for those wanting to become pregnant naturally, without having to take fertility medications or undergo other fertility treatments, such as in-vitro fertilization.
While these tubaligation reversal procedures do offer hope, not all women are candidates for them. The amount of remaining, viable fallopian tube for possible rejoining is a critical factor in determining whether a woman with a prior tubal ligation will be a candidate for reversal. The original technique used to perform the tubal ligation usually determines the amount of damage and it varies with each type of procedure. The woman's age, history of previous pregnancies and the potential fertility of both partners are also taken into consideration before performing the reversal tubal ligation.
Even if a woman is a candidate for reversal tubal ligation surgery, it is important to note that many insurance companies do not cover this procedure. Therefore, the costs associated with the surgery and follow up care may have to be covered out of pocket. The costs associated with each type of procedure vary, so that may also be a consideration when choosing which surgery to have.
The 3 most common procedures to reverse a tubaligation are ligation reversal by laparotomy, ligation reversal by mini-laparotomy and reversal by laparoscopy. With reversal by laparotomy, an incision is made in the abdomen and the blocked portion of the fallopian tubes is removed. The pieces of remaining tube are then reanastomised, or joined together. This method usually requires a 1-2 day hospital stay, with full recovery expected, on average, within 4 weeks.
The next method, reversal by mini-laparotomy, is an option for women who are within 20% of their ideal body. The mini-laparotomy is similar to the traditional laparotomy, but uses a much smaller incision. This requires less time in the hospital and a shorter recovery period. The least invasive reversal tubal ligation method is reversal by laparoscopy. Laparoscopy uses several very small incisions and the help of robotic tools to complete the reversal. Since this method is considered minimally invasive, it usually leads to the shortest hospital stays and fastest recovery times.
Regardless of which surgery is performed, the main risks involved are failure of the procedure to restore fertility and increased risk of ectopic pregnancy. The likelihood of an ectopic pregnancy after tubal ligation reversal is estimated at 5 - 10%. This is a life-threatening condition, so those looking to conceive after tubal ligation reversal should be aware of the signs and the risks.
Another consideration for many couples is the success rate of the reversal procedure. Success rates vary by age and method of original ligation, but on average 65% of patients will have a pregnancy after tubal ligation reversal surgery within one year. The success rate is slightly higher in women under 30 and significantly lower in those over 40. However, this success rate is still higher than the alternative of in-vitro fertilization.
It is important to note that while reversal tubal ligation procedures are possible, you should not have a tubal ligation done with the thought of having it reversed some day. There are many non-surgical, non-permanent birth control options available that are just as effective in preventing pregnancy, but restore fertility with much greater reliability.