Tubal ligation also referred to as “having your tubes tied,” is a procedure where your fallopian tubes are surgically blocked to prevent pregnancy. But what do you do if you’ve had a tubal ligation and now want children? Is it reversible? It can be. At Healthcare for Women, we can discuss your options and help put you on the path to having children.
About tubal ligation surgery
Women decide to get tubal ligation surgery for a variety of reasons. Most women decide they have had enough children and that they will not want any more.
After tubal ligation the regret rate approaches 35% and some of these women decide that they want a tubal ligation reversal. The most common reason that a woman has a tubal ligation reversal is because she got divorced, remarried, then she reverses her tubal ligation so her new husband can have a child.
Types of tubal ligation procedures
There are many types of tubal ligation procedures including:
Pomeroy Tubal Ligation:
- In this procedure, the fallopian tubes are “strangled (pinched)” with a suture (knot). The loop that is formed is usually cut and the end of the tubes are cauterized or “burned”.
- This method is usually very effective for reversal.
Tubal ring (Falope ring):
- A small silastic band is placed around a loop of the fallopian tube and 2-3 cm segment of the fallopian tube is passed through and secured.
- As the ring contracts due to its elasticity, it constricts the base of the loop and blocks the fallopian tube.
- Pregnancy success rates can be very high with this method if only the rings damage a small portion of the tube.
Tubal Clips (spring clip-Hulka clip):
- A hinged clip made of plastic with a gold spring lock is placed across the narrow muscular or isthmic segment of the fallopian tube, close to the uterus.
- The clip is compressed and the spring locks the clip tightly across the tube. Since the clip is only 7mm in width, there is minimal damage to the affected portion of the fallopian tube.
- The pregnancy rate is 76% at one year following reversal of tubal clip procedures and continues to rise with time.
Bipolar Coagulation (the most popular method of laparoscopic female sterilization):
- This method uses electrical current to cauterize sections of the fallopian tube.
- Depending on the number of sites coagulated, tube damage is typically only 2 or 3 centimeters in length and pregnancy rates after reversing this procedure are about 70%.
Fimbriectomy:
- Involves removing a portion of the fallopian tube closest to the ovary. It eliminates the ovary’s ability to transfer eggs to the fallopian tubes.
- Reversing this procedure involves opening the remaining fallopian tube and folding out the inner tubal lining so that egg capture is again possible.
- This procedure has the lowest success rate and repair is therefore not recommended. In vitro fertilization is usually the preferred treatment in these cases.
Salpingectomy:
- Involves the removal of the Fallopian tubes.
- It is completed to treat ectopic pregnancies, ovarian cancer, and used as a form of contraception.
- This type of tubal ligation has a very low chance of reversal (less than 10%). The reversal may be successful if some of the fallopian tube was left near the uterus and some portion of the ampulla has been left behind for repair.
Essure:
- This procedure involves placing a nickel coil into the opening of the tube from the uterine cavity using a hysteroscope. This type of tubal ligation has a very low chance of reversal as it usually involves implantation of the tube into the uterus.
Tubal ligation isn’t always permanent
Tubal ligation surgery is often described as permanent birth control. But this isn’t always true. A tubal ligation procedure can be reversed in some cases, giving women who are considering having children the opportunity to do so. Lyndon Taylor, MD, at Healthcare for Women will counsel you through your options and help you decide whether a tubal ligation reversal is right for you.
How the tubal ligation procedure works
First, it’s important to understand what tubal ligation is. Tubal ligation refers to a procedure that blocks your fallopian tubes. By blocking them, eggs cannot travel through the fallopian tubes, and sperm is unable to travel to the egg, thus not allowing fertilization to take place. This may seem permanent. However, due to advances in surgery, we may be able to reverse the procedure and reconnect your fallopian tubes.
Deciding on reversal
How do you know if you’re a candidate for tubal ligation reversal surgery? We at Healthcare for Women will go through the decision-making process with you, starting with examining your previous tubal ligation surgery. Some procedures are eligible for reversal, but others are not. It’s important that you get the operative report of your tubal ligation from the surgeon or hospital that did the surgery. We will also go over your health history, individual background, and fertility factors to ensure that this is a safe surgery for you.
Understanding the tubal ligation reversal procedure
Every tubal ligation reversal procedure begins with an initial consultation with our medical staff. We encourage potential candidates for this procedure to send us copies of their tubal ligation operative reports for a free evaluation. The information must include: Current height, weight and type of tubal ligation completed. This information will allow us to determine with a high degree if a patient is a suitable patient for tubal reversal surgery.
If accepted for the procedure, a simple CBC blood test will be completed at least one week prior to surgery but no more than 30 days prior to surgery.
A tubal ligation reversal procedure consists of the following:
First, a small 2 to 4 inch incision is made just above the pubic hairline. The blocked segments of the fallopian tubes are then reconnected to the remainder of the fallopian tubes. This connection may allow eggs from the woman’s ovaries to again move through the tubes and allow for fusion with sperm.
The surgery itself is outpatient, which means you can go home the same day to recover. The day after surgery, patients return to the office for a postoperative evaluation.
Risks associated with a tubal ligation reversal include:
- An inability to get pregnant after the procedure. Pregnancy rates following reversal of tubal ligation vary greatly depending on a woman’s age and the type of tubal ligation procedure completed.
- Infection
- Bleeding
- Scarring of the fallopian tubes
- Anesthesia complications
- Ectopic Pregnancy – when the fertilized egg implants outside the uterus, usually in a fallopian tube. It is important to notify your doctor as soon as you miss your period or think you may be pregnant. If you do this, an ectopic pregnancy may be diagnosed before it ruptures, then it can be dissolved with medication, preserving your tube. On the other hand, if your tube ruptures, it will have to be removed.
Tubal reversal frequently asked questions:
- How much does a Tubal Reversal surgery cost?
- Each patient has a free telephone consultation, which reviews your operative report.
- The surgery fee is $10,000. Compare that to In-Vitro fertilization which costs $10,000 every month you try to get pregnant. Success rates can range from 25-80%, over a years time. In-Vitro fertilization rates average 30% per cycle.
- Does health insurance, Medicare or Medicaid cover tubal reversal?
- Tubal Ligation Reversals are almost never covered by insurance, as they are considered an elective procedure. Once you schedule your surgery with us, we can perform a courtesy benefits check on your behalf. It’s also important to note that our office does not accept Medicare or Medicaid or HMO’s.
Surgery and recovery
Following your surgery, you will have about 7 to 10 days of recovery time before you can enjoy your normal activities and return to work. At follow-up appointments, we will make sure you’re recovering well and will discuss strategies for pregnancy.
Pregnancy after reversal
After the post-operative evaluation, patients may attempt to become pregnant as soon as they feel comfortable. Most patients will become pregnant within the first 12 months of having the reversal surgery. Tubal reversal surgery can be very successful at restoring your natural fertility, allowing you the chance to become pregnant, and providing you the ability to become pregnant more than once. It’s important to note that the success rates of women becoming pregnant following tubal ligation reversal surgery depend on the patient, and the type of tubal blockage you had.
Tubal Reversal is a personal choice
If you’re interested in tubal ligation reversal surgery, we encourage you to book a free consultation through our online booking tool or by phone. Tubal ligation reversal is only one of the many services the medical staff at Healthcare for Women can provide you in your fertility journey.
