Tubal Ligation Reversal
Tubal ligation reversal is a procedure that can help restore a woman’s fertility after she undergoes tubal ligation, a procedure for cutting or blocking the fallopian tubes in order to avoid pregnancy.
Sometimes, women who have gone through a tubal ligation might change their minds about having children and choose to have it reversed. This procedure reconnects the blocked or cuts segments of the fallopian tube, allowing a woman who had her tubes tied to once again become pregnant.
Purpose
The purpose of a tubal ligation reversal is to allow a woman to get pregnant by restoring her fertility without any further medical assistance.
It is important to note that tubal ligation reversal might not be for everyone. Your doctor will consider several factors before they recommend you for the procedure. These factors include:
- Your age and body mass index
- The type of tubal ligation
- Remaining tubal length
- The extent of the damage to your fallopian tubes
- Other fertility factors, such as sperm and egg quality
How success a tubal ligation procedure is, can depend on a variety of factors. If you have a large portion of the healthy fallopian tube remaining, then the procedure is more likely to be successful. If your tubal ligation was done using rings or clips, then it is more likely that the reversal procedure is going to be a success. Certain types of sterilization are not considered reversible.
Preparation
Before you undergo the procedure, it is likely that your doctor will explain the procedure to you in detail. He/she will also discuss how likely you are to have a pregnancy after the procedure. He/she might also discuss other options for pregnancy such as in vitro fertilization.
Procedure
First, your doctor looks at your fallopian tubes using a laparoscopic camera, i.e. a small camera that can be put in your abdomen through a tiny slit. If he/she sees that there is enough fallopian tube left to reverse your tubal ligation, only then the surgery will be performed.
Tubal ligation reversals are generally done with laparoscopic surgery. It is generally done with general anesthesia so that you are unconscious during the procedure and won’t feel any pain.
The surgeon first makes a few small slits in your abdomen, which should be around half inches long. Then he/she will put in a camera and a few small instruments for performing the surgery. The surgery can require around 2-3 hours.
Any damaged section of the fallopian tubes is next removed along with any devices from the tubal ligations such as clips or rings. Then with very small stitches, the ends of your fallopian tubes that are not damaged are reattached. After the tubes are reconnected, your surgeon will need to inject a dye into the end of each tube. If no dye leaks out then it indicates that the reattachment was a success.
Sometimes, your surgeon may also use a procedure called a minilaparotomy. In this method, he/she first makes an incision in your abdomen which should be around 2 inches.
They’ll then take the ends of the fallopian tube out of your abdomen through the slit. The surgeon will remove damaged parts of the fallopian tube and reconnect the healthy sections while the tubes are outside your body.
Recovery
Around three hours after the surgery you should generally be able to go home. Recovery for laparoscopic surgery can take around a week. Recovery for a minilaparotomy can take around two weeks.
During this time, you might experience pain as well as tenderness around the incision site. Your doctor may prescribe you pain medication or you may also use over-the-counter medication.
Before you take a shower or bath, it is important to wait for at least 48 hours. Remember not to rub the incision site. You can pat it gently instead. Avoid any heavy lifting or sexual activity for some time. You can discuss with your doctor how long these activities need to be avoided.
Around one week after the procedure, you should see your doctor for a checkup.
Results
The success rate can depend on multiple factors. There have been studies conducted to determine the success rate based on a few factors:
- Age- A study in 2015 revealed that people having surgery before the age of 40 had a 50 percent chance of being able to deliver a child. The chances however halve after crossing the age of 40.
- Weight- According to an older study in 2003, a woman with a body mass index less than or equal to 25 had an 85.4 percent chance of achieving pregnancy. Women with a BMI over 25 had a chance of 65.9 percent.
- Time after sterilization- The same 2003 study also revealed that those who received the procedure less than 8 years ago had a higher chance of becoming pregnant. If the sterilization procedure was performed more than eight years ago then the chances of being pregnant are less.
Risks
Women who undergo a tubal ligation reversal are usually at a higher risk of developing an ectopic pregnancy, a condition where the fertilized egg grows outside of the uterus usually in a fallopian tube. As the embryo continues to grow, it can cause a rupture in the fallopian tube. This is considered a life-threatening condition that requires urgent medical attention.
According to a study, around 4 to 8 percent of women who undergo the reversal procedure develop an ectopic pregnancy.
Other risks associated with this procedure include:
- bleeding
- scarring
- infection
- injury to nearby organs