What is Tubal Ligation Reversal?

Tubal ligation reversal is a surgery to repair a woman's Fallopian tubes after a tubal ligation surgery in order to restore fertility. The surgery may also be performed to treat post-tubal ligation syndrome, a condition that some women suffer after tubal ligation surgery. About six percent of women who choose tubal ligation consider tubal ligation reversal within five years.

In tubal ligation, a woman's Fallopian tubes, the structure through which her eggs reach her uterus, are closed so that fertilization and pregnancy cannot occur. The surgery is done with a small instrument called a laparoscope and usually requires only a small incision in the abdomen. The procedure is 99% effective at preventing future pregnancies.

Post-tubal ligation syndrome (PTS) can cause irregular periods, very heavy or painful periods, symptoms of early onset menopause, worsened premenstrual syndrome, vaginal dryness and loss of libido, trouble sleeping, and anxiety. There is also a risk of tubal pregnancy, in which a fetus begins developing in the Fallopian tube rather than in the uterus, following tubal ligation. Tubal ligation reversal can help reverse the effects of PTS.

Tubal ligation reversal uses microsurgery to repair the Fallopian tubes by rejoining the severed ends. Success rates for tubal ligation reversal vary widely, from 20% to 70%. Women over 40 are usually not recommended to undergo the procedure. Tubal ligation reversal has a greater chance of success if the Fallopian tubes were minimally damaged in the tubal ligation, especially if they were restricted with a clip or ring rather than cut. If only a small section of Fallopian tube was removed, the chance of a successful tubal ligation reversal is also improved.

One of the greatest factors for the success of tubal ligation reversal is the relative size of the ends of Fallopian tube to be rejoined. If they are the same diameter, there is a better chance of successful surgery. Also, a woman who has had a tubal ligation reversal is more likely to become pregnant in the future if her Fallopian tubes after surgery are at least four inches long, half the length of an average Fallopian tube before tubal ligation.

If a woman who has had a tubal ligation wishes to become pregnant again, tubal ligation reversal is not the only option. Because her ovaries and uterus are still functional barring complications from the tubal ligation, in vitro fertilization is also possible. A woman considering tubal ligation reversal should discuss her chance of becoming pregnant again and other options with her doctor carefully before making a decision.