Tubal Reversal Surgery
Although typically thought to be a permanent procedure, some types of tubal ligation can be successfully reversed. Contrary to popular belief, tubes are not really “tied”. Instead, during a minor surgical procedure, the fallopian tubes are either cut, burned or clipped. Each different type of ligation procedure causes a different amount of tubal damage. The more damage to the tube, the less likely it is that the tubes can be repaired. It is therefore important to know what kind of tubal ligation you have had.
The electrical current typically used to “burn” the tubes can transmit energy for over an inch along the tubal course. This often leads to significant tubal damage, reducing the likelihood of a successful reversal. Clips or rings, on the other hand, do not cause extensive tubal damage, so these types of procedures can more often successfully be reversed.
A tubal reversal involves cutting out the part of the tube that has been damaged. The two fresh ends are then sewn back together using very small suture placed with the aid of a surgical microscope. The entire procedure typically takes a couple of hours, after which you should be able to go home. We will most likely ask you to avoid pregnancy for at least 6 weeks, in order to allow any post-surgical tubal swelling to resolve. Other than that, there is really no wait time to try to get pregnant.
A high percentage of patients who have a tubal reversal are successful in achieving pregnancy. However, there are possible complications that you should understand.
- First, it is possible for the tubes to scar closed after the surgery. Therefore, if you have not successfully conceived after six months or so of trying after your tubal reversal, you should have an HSG (hysterosalpingogram) to determine if the tubes are still open.
- You will have an increased risk of having an ectopic or tubal pregnancy following a tubal reversal. The lumen of the tube is very small, and even microscopic scarring after the procedure can cause the lumen to be further narrowed. Therefore, as soon as you have a missed period, you should let your doctor know so you can be closely monitored with blood tests and ultrasound examinations.
- If you are over the age of 35 or have poor ovarian reserve, you may still need to have fertility treatment in order to conceive after your tubal reversal. Just because it was very easy to conceive before having your tubal ligation does not mean that you will conceive easily afterward. This is most often related to the fact that a woman may be significantly older when she is trying to conceive following a tubal reversal than she was when she conceived initially.