REVERSE TUBAL LIGATION

Tubal ligation, also called having the "tubes tied," is very popular among women who want permanent birth control. Tubal ligation is an operation that cuts and blocks a woman's fallopian tubes. The fallopian tubes are the tubes that carry the eggs from the ovaries to the uterus where they are fertilized by the sperm.

If a woman decides later that she wants more children, she has three options:

assisted reproduction, such as in vitro fertilization
adoption or
a tubal ligation reversal, an operation to reconnect the fallopian tubes

The choice between a tubal reversal, or in vitro fertilization, depends on the woman's age, method of tubal ligation, finances, and the patients desires. Information about the type of tubal ligation done will be needed before a decision can be made. During reversal, the damaged part of the tube is removed and the good ends are sewn back together. There must be enough length of the tube to reattach it.

Tubal reversal works best for women in good health, in their late thirties or younger, who have a fertile partner. The results are best from this surgery if it has been 10 years or less since the original tubal surgery, and only small sections of the tubes have been damaged by the previous surgery. A physical exam, tests, and review of the original tubal ligation is done to find out if the woman is a good candidate for this surgery.

A surgeon who is specially trained and experienced in reproductive surgery should perform the procedure. The procedure may be done with a single incision into the abdomen. A microscope is used so the small tubes can be seen easily. Another method is done with several small cuts in the abdomen. A laparoscope (small lighted telescope) is put into one of the small cuts so the surgeon can see inside the abdomen. Instruments can be put in the other cuts to do the surgery. The surgery usually takes several hours. It may take several days to recover from the surgery. Activities at home should be reduced for several weeks.

The success rate varies with the woman and the surgeon. The pregnancy rate after a successful tubal reversal is very high. If there is a pregnancy, there is greater risk that the pregnancy will be in the tubes. This is called a tubal pregnancy.

Most health insurance does not cover the cost of a tubal reversal. Reversing a tubal ligation is a difficult decision. Use all the information available and ask appropriate questions before making a final decision.

For more information about tubal reversal, contact your healthcare provider or visit the website of the InterNational Council on Infertility Information Dissemination at www.inciid.org or the website of EngenderHealth, a non-profit organization dedicated to making reproductive health care accessible to women and men around the world, at www.engenderhealth.org.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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