Tubal reversal surgery and achieving pregnancy

Although commonly described as a permanent procedure, some types of tubal ligation can be successfully reversed. During a tubal ligation surgery for contraception, the fallopian tubes can be tied and cut, burned, clipped, or even completely removed. Each different type of ligation procedure causes a different amount of tubal removal. If you’re considering tubal reversal surgery, it is important to know what kind of tubal ligation you have had.

The electrical current typically used to “burn” the tubes can transmit energy for more than an inch along the tubal course. This often leads to significant tubal damage, reducing the likelihood of a successful reversal. Clips or rings, on the other hand, do not cause extensive tubal damage, so these types of procedures offer more of a chance to be reversed. For women who have had the tubes removed, IVF is the only way of conceiving in the future.

A tubal reversal involves cutting out the part of the tube that has been damaged

During tubal reversal surgery, the two remaining ends of the fallopian tube are sewn back together using very small sutures, often with the aid of magnification. The entire procedure typically takes a few hours, and the surgeon usually confirms that the tubes are hollow and completely open before the procedure is completed. After a few weeks of surgical healing, your physician may encourage you to try for up to six to 12 months for pregnancy.

While reversal surgery can be successful for some patients, more patients seeking pregnancy after this surgery are successful after IVF, a procedure designed to bypass the tubes without having to have tubal surgery again.

Like all surgeries, tubal reversal surgery can have complications that women need to understand prior to surgery.

• First, it is possible for the tubes to scar closed after the surgery. Therefore, if you have not successfully conceived after six months or so of trying after your reversal, you should have an HSG (hysterosalpingogram) to determine if the tubes are still open.
• You will have an increased risk of having an ectopic or tubal pregnancy following a tubal reversal. The cross-section of the tube is very small, and even after the most careful and successful surgery, the procedure can cause the pathway for the embryo to be quite narrowed. Therefore, as soon as you have a missed period, you should let your doctor know, so you can be closely monitored with blood tests and ultrasounds to make sure the pregnancy is inside the uterus and not the tube.
• If you are older than 35 or have low ovarian reserve, you may still need to have fertility treatment to conceive after your reversal surgery. Just because it was very easy to conceive before having your tubal ligation does not mean that you will conceive easily afterward. This is often because a woman may be significantly older when she is trying to conceive following a reversal than she was when she conceived initially, and fertility rates may be less than half of what they were originally.

Texas Fertility Center has been a leader for decades in helping women successfully conceive after tubal reversal. With advances in IVF, most women who have had tubal ligation can be successful at conception. Please contact us to discuss your options after surgery, and let us help you on the right path to parenthood.