Medical Editor Mark Kan, MD, offers some information about the reversal of tubal ligation and the potential of future pregnancies.
How often are tubal reversals successful? What needs to be done to reverse tubal sterilization?
The expert answers
Tubal sterilization is generally considered a permanent procedure. While it is not always possible, reversal of sterilization procedures can be attempted in appropriate patients. An alternative to tubal reversal surgery is in-vitro fertilization (IVF), which bypasses the tubes altogether, and can also lead to a successful pregnancy.
The method of initial tubal sterilization is important. Because tubal sterilization requires the tubes to be tied, clipped or burned with electrical current, there is always fallopian tube damage. This damage often precludes successful reversal surgery. The operative report from the initial surgery will detail which technique was performed. A patient considering this procedure should have a complete work-up, checking for male infertility, normal ovulation and other causes of infertility.
A hysterosalpingogram (X-ray test of the uterus and tubes) is routinely performed to check the status of the uterine cavity and proximal fallopian tubes. These tests are performed to ensure there are no other reasons for infertility before an elective reversal surgery. Given the appropriate candidate, reversal techniques have reported success rates between 50 to 80 percent. Additional benefits include a lower rate of multiple gestation when compared to IVF and the ability for future conception without additional procedures. It is important to know that even in the best candidates, the surgery may not be possible or successful. In addition, there are routine surgical risks involved with laparoscopy and laparotomy.
A reproductive endocrinology and infertility specialist is a reproductive surgeon trained in both tubal surgery and IVF. These specialists can explain the risks and benefits of both procedures, and help you make the best decision for achieving pregnancy.