Overview
A tubal reversal is a procedure to reconnect the fallopian tubes in a woman who has previously undergone surgical sterilization, known as tubal ligation. In a tubal reversal operation, the surgeon removes the portion of each fallopian tube that has been blocked or cut. Once the damaged portion has been removed, the tubes are reconnected to form a complete, open fallopian tube. The fallopian tube is the passageway through which the released eggs travel and meet with a man's sperm and become fertilized.
A tubal reversal, also known as tubal reanastomosis, is usually performed when a woman wants to try to achieve pregnancy after undergoing a tubal ligation. In many cases, surgery for tubal reversal is successful. However, a number of factors can affect the success of the procedure. Estimates vary, but health experts approximate somewhere between 50 to 75 percent of tubal reversals are successful in reopening the fallopian tubes. However, the success rate may be much lower. A tubal reversal is the only procedure that can open the fallopian tubes.
Good candidates for this procedure include women who have : -
- Adequate tubal segments remaining
- No other significant fertility problems such as non-viable eggs or ovulation dysfunction
- A partner whose sperm analysis is normal
- No other health conditions that might prevent pregnancy
A successful tubal reversal does not guarantee pregnancy. In addition, the surgery is expensive and may not be covered by medical insurance. Women who have a tubal reversal are at increased risk for ectopic pregnancy. For this reason, many health experts recommend that sterilized women consider in vitro fertilization as an alternative to tubal reversal.
About tubal reversal
A tubal reversal is a procedure to undo a tubal ligation, which is the surgical sterilization of a woman. Also known as tubal reanastomosis, the procedure is usually performed when circumstances have changed and a woman wishes to have a child.
In women of childbearing age, one egg (ova) from an ovary moves into the fallopian tube each month. There, the egg can be fertilized by a man's sperm produced in ejaculation during sexual intercourse. Once the egg has been fertilized, it travels down into the uterus (the hollow, muscular cavity in a woman's pelvis) and implants in the uterine wall, where it develops into a fetus. In a tubal ligation, the fallopian tubes are separated or sealed shut to prevent the sperm from reaching and fertilizing the egg.
a woman may change her mind and decide to have the procedure reversed. Common reasons for seeking a tubal reversal include change in marital status, death of an offspring or husband, or young age at the time of the procedure (e.g., younger than age 30). In the past, tubal reversal usually meant major surgery. However, advances in surgical techniques now make outpatient surgery an option for many women.
In a number of cases, surgery to reverse a tubal ligation can be successful. Estimates vary, but depending on circumstances, health experts estimate the success rates to be anywhere from 25 to 75 percent.
Factors that influence the likelihood of reopening the fallopian tubes include : -
- Technique used during tubal ligation : - Women whose tubes were blocked off or clamped with clips or rings are more likely to have a successful reversal than women whose tubes were cauterized (closed using electric heat) or who had a large section of the tube removed. Many experts say that at least 1 inch of healthy tube must remain if tube reconnection is to be successful.
- Age : - Women who are younger are more likely to experience a successful reversal of a tubal ligation. Women over 40 years of age who desire to have children may want to consider in vitro fertilization (IVF) instead of a tubal reversal. IVF involves removing mature eggs from the woman's ovary, fertilizing them with donated sperm and then surgically implanting the eggs into the woman's uterus. This procedure does not require fallopian tubes. However, IVF is expensive and is not guaranteed to work.
- Woman's reproductive health : - Pelvic diseases such as scarring or endometriosis may affect the success of the tubal reversal.
Before the tubal reversal procedure
A woman considering a tubal reversal must first determine if she is eligible for the procedure. In some cases, the initial sterilization may have prevented any hope of reversal. For example, a sterilization technique known as fimbriectomy involves removal of the end of the fallopian tube. This type of sterilization generally cannot be reversed. In addition, reversal may be difficult if sterilization was achieved through cauterization (using electric heat). This type of sterilization may damage more of the fallopian tubes, resulting in a greater difficulty with reconnection.
Potential risks with tubal reversal
Risks associated with a tubal reversal include those generally associated with surgery (including bleeding and infection) and use of anesthesia (including reaction to the anesthetic).
Other risks include : -
- Formation of scar tissue
- Increased risk of ectopic pregnancy
- There is a small chance that the tubes will become blocked again following a tubal reversal.
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