Tubal Ligation Reversal

What is Tubal Ligation?
Tubal ligation or “having your tubes tied” is a form of permanent birth control that many doctors recommend for women who are certain that they do not wish to become pregnant anymore or when it is believed that pregnancy could be a serious health risk. The procedure severs or blocks the fallopian tubes so that ova (eggs) cannot be fertilized or reach the uterus. Its success rate is over 99% during the first year. In following years, spontaneous recovery of the fallopian tubes may reduce its effectiveness to some extent. For this reason, sometimes very aggressive means are used to perform the tubal ligation.

What kinds of Tubal Ligation are there?

The most common kind of tubal ligation is known as Partial salpingectomy, which involves cutting and tying the tubes.

Clips or silicon rings may be used either on or in the tubes. Clips in the tubes cause scar tissue to develop around them, hence preventing the passage of the sperm to the ovum.

Electrocoagulation or cauterization are methods that use electric currents to burn the tubes.

Often women will refer to their tubal ligation saying that their tubes were, "cut, tied and burned"- meaning that a combination of methods was used to perform their tubal ligation.

How successful is tubal reversal?

While the surgery itself is successful in the majority of cases (some sources quote statistics as high as 98%), pregnancy rates vary depending upon a variety of factors such as other health problems, the quality of the woman's eggs and the partner's sperm, among other things. If all is well, a successful tubal reversal provides a 75% chance of spontaneous pregnancy for the couple within a year.

Who is a good candidate for tubal reversal?

• Women under age 40, as their ova tend to be of higher quality.
• Women without evidence of significant scar tissue resulting from the tubal ligation.
• Couples for whom sperm quality is not a factor - for these couples, IVF (often combined with ICSI) has higher success rates than tubal ligation reversal.

Tubal Reversal Versus IVF
For women who have had tubal ligation, IVF (in-vitro fertilization) is another option for conception.

Tubal reversal and IVF yield similar success rates, yet for those who are good candidates for tubal reversal, it does have several advantages:

• Cost: the price of tubal reversal is similar to the price of a single cycle of IVF, but gives the option of trying month after month at home
• No need for additional medical intervention to achieve pregnancy - the woman does not need to take any medications or go through any additional medical procedures (following a successful tubal ligation reversal) in order to conceive.
• Additional Pregnancies: If tubal reversal is successful, additional pregnancies will not require additional intervention

What other options are there for a woman who has had a tubal ligation to conceive?

Using donor eggs with the help of IVF can allow a woman to carry a baby. Surrogacy, using either the woman's or the surrogate's ovum are additional options that are available.

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