Tubal ligation is a common surgical procedure in the U.S. that patients commonly refer to as getting their “tubes tied.” This is a permanent contraceptive method that clamps, cuts, blocks or seals a woman’s fallopian tubes in order to stop egg fertilization and block the egg’s path to the uterus, thereby eliminating her fertility.
If a woman’s circumstances change and she wants to become pregnant, a tubal ligation reversal can reopen the fallopian tubes to allow the normal reproduction process to occur, restoring a woman’s fertility.
A tubal ligation reversal may be sought for several reasons, including:
A tubal ligation reversal seeks to remove the closed portion of the fallopian tube and reconnect the remaining segments to restore reproductive function. If successful, sperm can once again reach the egg for fertilization, and the egg can move to the uterus. Previous tubal ligations that cause the least damage to the fallopian tubes are most likely to be successfully reversed. Success in reversing tubal ligation depends on the amount of tube left after the repair (the longer the better) and where the repair is performed: if the segment of tube closest to the uterus is the site of the repair it carries the highest success rate.
Tubal ligation reversal may be all that is needed for a woman to achieve pregnancy, without any other assisted reproductive procedures, such as IVF or IUI.
Whether or not a tubal ligation is an appropriate procedure to effectively treat infertility is determined by several factors, including:
Tubal ligation reversal is usually more successful when a large portion of the fallopian tube has been left intact. For instance, it is easier to reverse a tubal ligation that was performed using rings or clips to block the tubes than a procedure that burned the tubes to close them off.
Traditionally, tubal ligation reversal takes two to three hours. The woman is put under general anesthesia so the surgeon can reattach, unclamp or implant an extension in the fallopian tubes to make them functional. A hospital stay of at least one night and up to five is required for adequate healing, with full recovery taking four to six weeks.
New advances in technology and microsurgery, however, have enabled some doctors to perform tubal ligation reversals with less invasive techniques, shortening surgery time to less than an hour using local anesthesia and making it an outpatient procedure (not requiring a hospital stay). This technique reduces risk of complications or injury, and allows the patient to recover within five to ten days. Robotic surgery, a type of minimally invasive or laparoscopic surgery, can usually be used and allows for much faster recovery for the patient.
Rare side effects of tubal ligation reversal surgery include:
Risks associated with tubal ligation reversal include:
Other risks to consider include discovering the fallopian tubes are unrepairable, or repairing the tubes but inability to conceive continues. If pregnancy is achieved, there is a 4 percent to 7 percent chance of an ectopic pregnancy, when the fertilized egg implants outside of the uterus – usually in the fallopian tube itself.