Tubal Ligation Reversal 2018-04-20T13:29:07+00:00

Tubal Ligation ReversalTubal Ligation Reversal

At UAMS, we understand that changes in life can sometimes cause you to reevaluate a decision to stop adding to your family. Our fertility specialist is an expert in performing tubal ligation reversal procedures.

Tubal ligation is a procedure that cuts, burns, or places clips or loops to damage part of the fallopian tube to separate preventing sperm from reach the egg for fertilization. Tubal ligation procedures that caused the least amount of damage are most likely to allow a successful reversal procedure. Tubal clips are the least destructive procedure. Hysteroscopic (Essure) tubal ligations cause scarring to seal off the fallopian tubes, and these are generally not reversible.

When tubal ligation reversal is possible, this may be a more affordable and successful option as compared to in vitro fertilization, allowing you to get pregnant without further medical treatment.

While a tubal ligation cuts or blocks the fallopian tubes to prevent pregnancy, the blocked segments of the fallopian tubes can often be reconnected to the remainder of the fallopian tubes using an operative microscope through a mini-laparotomy incision. This may provide a way for eggs to again move through the tubes and sperm to join the egg.

While this minimally invasive surgery is not right for everyone, our expert offers personalized treatment to ensure you have the best chance of adding to your family.

Tubal reversal is successful in the majority of women, especially women under 40 years of age. The tubes can be reconnected with a patency rate of about 85%. When considering tubal reversal, the woman’s age is the most important prognostic factor. The cumulative intrauterine pregnancy rate for tubal reversal at two years is 70%, compared with more than 90% after microsurgical reversal of tubal sterilization in women less than 40. Even in women 40-45 years old, cumulative intrauterine pregnancy rates of 41.7% – 70.6% have been reported. Isthmic-isthmic repairs and longer final tubal lengths are generally thought to yield higher success rates, although this is not a universal finding. The rate of ectopic pregnancy after the procedure is 2%. Tubal anastomosis should not be considered when the final tubal length is less than 4 cm, there are significant tubo-ovarian adhesions or stage 3-4 endometriosis, and/or there is more than a mild male factor. When tubal reversal is not an option, in vitro fertilization is another way to achieve pregnancy post tubal ligation.

Summary

Factors to be considered when counseling patients having tubal infertility regarding corrective surgery or IVF include multiple factors, such as:

  • Age of the woman and ovarian reserve
  • Number and quality of sperm in the ejaculate
  • Number of children desired
  • Site and extent of tubal disease
  • Presence of other infertility factors
  • Risk of ectopic pregnancy and other complications
  • Experience of the surgeon
  • Success rates of the IVF program
  • Cost
  • Patient preference

There are no adequate trials comparing pregnancy rates with tubal surgery versus IVF. However, IVF has a higher per cycle pregnancy rate (SART 2015 data is 53.9%/ IVF cycle). Tubal anastomosis for reversal of tubal sterilization has a significantly higher cumulative pregnancy rate than IVF, and it is more cost-efficient, even in women 40 years of age or older.

UAMS Fertility Center offers tubal reversal or reanastomosis as an outpatient procedure at low cost. We have partnered with Little Rock Surgery Center to give you the lowest cost package. We are very conscious of the fiscal strain paying for medical care places on families. We do our best to contain cost but not compromise outcome and patient satisfaction. Our financial counselors are here to help. Call 501-526-7425 for an appointment or if you have further questions.

To learn more, please contact the UAMS Fertility and Reproductive Endocrinology Clinic.