Tubal Ligation Reversal

Tubal ligation reversal may be a method to reestablish ripeness in ladies who have had tubal ligation - a method that cuts or pieces the fallopian tubes to avoid pregnancy.

Tubal ligation reversal

The form of contraception where the fallopian tubes are tied, thus preventing the eggs released by the ovaries from entering the uterus, and the sperm from reaching the egg is called tubal ligation. Tubal ligation reversal (TLR) or tubal reanastomosis is the surgical method used to reverse tubal ligation and may be an option for women, who for various reasons, wish to reestablish their fertility. In this procedure, the fallopian tubes are reconnected and made functional again through a surgical procedure that is often a minimally invasive, same-day surgery.

Roughly 50-80% of women who have TLR go on to have a successful pregnancy. This will depend on several factors including :

  • The woman's age
  • Type of tubal ligation originally performed and the length of her remaining healthy tubes.
  • Length of the remaining fallopian tube segments to be rejoined
  • Overall health and the health of the ovaries, uterus, and remaining fallopian tubes, and
  • Skill of the microsurgeon

In general, tubal reversal could be the right choice if only small parts of the fallopian tubes had been removed, or if the tubes had been closed with rings or clips.

How is it done?

TLR is a daycare procedure that is done mostly through minimally invasive laparoscopy these days. The patient and her partner will be required to get a complete physical exam in preparation for the surgery. That way it can be made sure that there would be nothing preventing pregnancy after the tubal reversal procedure.

General anaesthesia is usually given to the patient to induce unconsciousness. A laparoscope is introduced through a cut in the belly button and further into the pelvis area. This gives a good view of the fallopian tubes and then a decision is taken on whether reversal surgery is possible. If the decision is positive, the doctor then makes a small surgical cut, called a "bikini cut," near the pubic hair line. Microscopic instruments attached to the end of the laparoscope are used to remove any clips or rings that were used to block the fallopian tubes. The ends of the tubes are then reconnected to the uterus using very small stitches. The surgery usually takes about 2 to 3 hours.

Today, tubal reversal surgery is most often done using microsurgical techniques and hence an overnight hospital stay may not be needed. The doctor may prescribe painkillers to help manage any discomfort. Most women go back to their normal a ctivities within 2 weeks.

What are the risks?

The common risks from surgery include bleeding, infection, damage to nearby organs, and reactions to anaesthesia. In tubal reversal surgery, the risk of ectopic pregnancy is also increased. Sometimes, the area where the tubal reversal procedure was done forms scar tissue and blocks the fallopian tubes again.

It's possible to reverse a tubal ligation and have a successful pregnancy if the remaining fallopian tubes are healthy, and both partners don't have any other infertility issues. However, there are many factors to consider when deciding if a reversal is the right choice. Consult with your doctor about your options for future pregnancy .