Tubal-ligation reversal (tubal reanastomosis) is a procedure that "undoes" tubal ligation, which is a surgical procedure that prevents pregnancy by closing off the fallopian tubes. During tubal ligation, a surgeon cuts the fallopian tubes, and closes them with bands or clips, or seals them using electrical current. Tubal-ligation reversal reconnects the fallopian tubes so that a woman has a chance of becoming pregnant.
Candidates for Tubal-Ligation Reversal
There are several factors that determine whether a woman is a candidate for tubal-ligation reversal:
- Extent of damage to the fallopian tubes
- Age and weight
- Remaining tubal length
- Fertility factors, such as egg and sperm quality
A complete physical exam is given to the woman (and her male partner, if there is one) to determine whether tubal-ligation reversal has a chance of succeeding. A hysterosalpingogram, which checks the remaining length and function of the fallopian tubes, may be performed. To rule out infertility issues in the male partner, semen analysis may be performed, or a sperm count taken.
The Tubal-Ligation-Reversal Procedure
Tubal-ligation reversal is performed with the patient sedated under general anesthesia. It can be an outpatient or inpatient procedure, and typically takes about 1 to 3 hours. During the procedure, a laparoscope (a small lighted scope) is inserted through the navel into the pelvis to determine if tubal reversal is possible. A small incision is made in the abdomen to expose the uterus, fallopian tubes and ovaries. Bands or clips used to block the tubes are removed, and the viable portions of the tube are reattached using absorbable stitches.
Recovery from Tubal-Ligation Reversal
Recovery from tubal-ligation reversal takes 1 to 2 weeks. Painkillers to ease discomfort during the recovery period are prescribed. The patient can bathe 2 days after the procedure, but should avoid straining or rubbing the incision site for 1 week. The patient should also refrain from sexual activity or strenuous lifting for 2 weeks. A follow-up appointment may be necessary to ensure that the patient is healing properly. Another hysterosalpingogram may be needed in 3 to 4 months to determine whether the fallopian tubes are working properly.
Risks and Considerations of Tubal-Ligation Reversal
There are several factors that must be considered prior to undergoing tubal-ligation reversal. For one, it is costly, and insurance does not typically cover it. And because tubal ligation reversal is a form of abdominal surgery, it has risks that include the following:
- Damage to nearby organs
- Reaction to anesthesia
The success of tubal-ligation reversal varies because, for pregnancy to be achieved, there must be an adequate length of healthy and functional fallopian tube for a fertilized egg to travel to the uterus. Unfortunately, there is no guarantee that a reconstructed tube will be functional. Depending on the patient and related factors, pregnancy rates following tubal-ligation reversal vary greatly.