Tubal Ligation Reversal

Tubal ligation reversal is a safe and effective procedure which involves reconnecting a woman’s fallopian tubes once they have been “tied” (tubal ligation). Although tubal ligation is often thought of as a permanent, irreversible form of contraception, tubal ligation reversal is an outpatient surgical procedure allowing the possibility of pregnancy.

Approximately 6% of women will request information about tubal ligation reversal within 5 years of tubal ligation. While there are other methods of fertility treatments (such as In Vitro Fertilization, or IVF) that offer similar success rates, some benefits of tubal ligation reversal may make this method a more attractive option. Some of these perceived and actual benefits are:

  • Natural conception
  • Lower risk of multiple pregnancy
  • Lower cost

Various methods can be used to perform a tubal ligation. The chances of achieving a pregnancy following a tubal reversal depend on the method used to “tie” the tubes.

Some of the many methods of tubal ligation include:

  • Ring or clip to occlude the tube
  • Removal of some of the fallopian tube
  • Cautery/burning a portion of the tube

Of the methods listed, application of a ring or clip to the tube offers the best outcome following tubal reversal as it involves the least amount of tubal damage.

Removal of a portion of the fallopian tube is commonly performed in conjunction with a Cesarean section. Cautery of a portion of the fallopian tube is often performed as a laparoscopic procedure. These types of ligation are generally amenable to reversal, but are dependent on the length of fallopian tube removed or burned at the time of surgery. An estimate of the length of tube that was removed can be obtained from the pathology report which is created at the time of tubal ligation.

Tubal Ligation Reversal Procedure

The operation is usually performed on an outpatient basis, using a very small (5-8 cm) bikini-type incision. The operation typically takes 2-3 hours. Numbing medicine is injected into the skin after the operation so that the patient is comfortable enough to leave the surgery centre several hours post operative. Recovery time is shorter because of the small incision size, but your ability to return to normal activities or work will vary.

Pre-procedure Testing

There are a few reports which should be obtained obtain prior to undergoing tubal ligation reversal. While these items are not essential, they are recommended. They are:

Operative report and pathology report of tubal ligation (frequently obtained from the surgeon or hospital where the procedure was performed)
Sperm function testing to rule out other fertility issues (this testing can be performed at PCRM)