During a tubal ligation reversal, the blocked segments of the fallopian tubes are reconnected to the remainder of the fallopian tubes. This allows eggs to move again through the tubes and sperm to travel up the fallopian tubes to join an egg and thus making the pregnancy possible anew.
Tubal ligation procedures that cause the minimal amount of damage to the fallopian tubes are the ones which are most likely to allow a successful tubal ligation reversal. Tubal ligation reversal is more likely to be successful if the patient’s tubal ligation was originally done using clips or rings, rather than if segments of the fallopian tubes were burned in order to close them off. Procedures that cause scarring to seal off the fallopian tubes, such as the Essure or Adiana Systems, generally aren’t reversible and therefore not suitable for tubal ligation reversal. In such cases, in vitro fertilization (IVF) may be an option.
Tubal Ligation Reversal is done as a minimally invasive surgical procedure called Laparoscopic Tubal Reversal using small, specially-designed instruments to repair and reconnect the fallopian tubes. After general aesthesia, has been administered, a 10mm (less than ½-inch) tube (trocar) is inserted just at the lower edge of the navel, and a special gas is pumped into the abdomen to create enough space to perform the operation safely and precisely. The laparoscope (a telescope), attached to a camera, is brought into the abdomen through the same tube, and the pelvis and abdomen are thoroughly inspected. The fallopian tubes are evaluated and the obstruction (ligation, burn, ring, or clip) is examined. Three small instruments (5mm each, less than ¼-inch) are used to remove the occlusion and prepare the two segments of the tube to be reconnected. Once the connection (anastomosis) is completed, a blue dye is injected through the cervix, traveling through the uterus and tubes, all the way to the abdomen. This is to make sure the tubes have been aligned properly and that the connection is working well.
When performed by a trained laparoscopic tubal reversal surgeon, laparoscopic tubal reversal combines the success rates of micro-surgical techniques with the advantages of minimally-invasive surgery – namely faster recovery, better healing, less pain, fewer complications, and no large disfiguring scars.
The surgery usually takes about 2 to 3 hours and is done under general anaesthesia. .
A tubal ligation reversal isn’t appropriate for everyone. Your health care provider will consider various factors to determine if tubal ligation reversal is likely to be successful, such as:
- the type of tubal ligation procedure undergone previously
- Length of remaining fallopian tubes, and whether they still work properly
- Amount of scar tissue in the pelvic area
- Results of your partner’s sperm count and other fertility factors
If the remaining fallopian tubes are healthy, and the patient or their partner don’t have any other infertility issues, they have a good chance of getting pregnant after the tubal ligation reversal.
Overall, pregnancy success rates range from 30% to 85%. When pregnancy does happen, it’s usually within the first year after the reversal. Younger women — particularly those 35 and under — tend to have much better success rates of getting pregnant after the procedure.