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Tubal Ligation Reversal

What is tubal ligation reversal?

Tubal ligation reversal is an operation that may be done in some cases after you have had tubal sterilization. Tubal sterilization, also called tubal ligation or having your tubes tied, is a permanent way to prevent pregnancy by surgically closing a woman's fallopian tubes. It is considered to be a permanent type of birth control.

Normally, the fallopian tubes carry the eggs from the ovaries to the uterus. Tubal ligation closes the tubes by cutting, tying, clipping, or burning the tubes, or by plugging the opening of the tubes. It prevents pregnancy because it stops sperm from reaching and fertilizing eggs after you have sex. It also prevents eggs from reaching the inside of the uterus (womb).

Tubal ligation reversal is an operation to try to reconnect or unblock the fallopian tubes so that you may be able to get pregnant again, naturally. Tubal ligation reversal is difficult, expensive, and often not successful. Health insurance may not cover the cost. Talk to your healthcare provider to see if this procedure is right for you.

When is this procedure used?

If you decide that you want to become pregnant again after sterilization, having surgery to reverse tubal ligation is one way that might make this possible. It does not always work, but it may be less expensive than other procedures. If it is successful, you will not likely need any other treatments to have more children.

Another way to try to get pregnant after sterilization is assisted reproduction technology (ART). When ART is done, eggs are removed from your body and fertilized with sperm in a lab. Healthy-looking fertilized eggs are then returned to your uterus or fallopian tubes. In vitro fertilization is an example of an ART method. ART is usually more expensive than tubal ligation reversal, and you may have to do it several times before you become pregnant, or it may not work at all. You will need to have the procedure again every time you want to get pregnant.

The choice between a tubal reversal and ART depends on your age, the amount of damage to the tubes, cost, the quality of your partner's sperm and your eggs, and your history of pelvic infections. Reversal works best for women who are healthy and younger than 38 years old. The best results happen if it has been 10 years or less since the original surgery, and if only small sections of the middle of the tubes were damaged.

How do I prepare for this procedure?

Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest. Try to find other people to help you with your day-to-day duties.

Be sure to tell your healthcare provider what medicines you are taking, including nonprescription drugs and herbal remedies.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.

Follow any other instructions your provider gives you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

A surgeon who is specially trained and experienced in this type surgery should perform the procedure. It is usually done by making a cut in the abdomen while you are asleep under general anesthesia. The surgeon will remove the damaged part of the tubes and sew the good ends of the tubes back together.

What happens after the procedure?

If the surgery is successful, fertility (the ability to get pregnant) returns right away. If you have sexual intercourse during the fertile times of your cycle and do not become pregnant within 3 months after reversal, you should see your healthcare provider. Your provider will determine if the fallopian tubes are able to take eggs from the ovary to the uterus.

What are the benefits?

If the surgery is successful, the chances of getting pregnant again approach 80%. You will probably not need any other procedures to have more babies.

What are the risks?

All surgeries have risks related to anesthesia and the surgery itself. Possible risks include:

  • There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider.
  • The abdominal organs, glands, intestines, or blood vessels may be damaged. You may need abdominal surgery to repair them. However, this is rare.
  • The lining of the abdominal wall may become inflamed.
  • Scar tissue (adhesions) may form on the pelvic organs.
  • You may develop an infection or bleeding.
  • You may not be able to get pregnant after the surgery.
  • If you do become pregnant after this procedure, there is a greater than normal risk (3 to 5%) that the pregnancy will be in the tubes. This is called a tubal or ectopic pregnancy. If this happens, you will need to see a healthcare provider right away.

When should I call my healthcare provider?

Call your provider right away if:

  • You develop a fever over 100°F (37.8°C).
  • You cannot urinate or you have pain or a burning feeling when you urinate.
  • You have pain in your abdomen or your abdomen becomes swollen.
  • You become short of breath or have chest pain.
  • You have heavy bleeding from the vagina.

Call your provider during office hours if:

  • You have questions about the procedure
  • You want to make another appointment.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File sexr4330.htm Release 13/2010

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