A Guide to Tubal Ligation Reversal
Sex and gender exist on a spectrum. This article uses the terms “female” and/or “male” to refer to sex that was assigned at birth.
Tubal ligation blocks or fuses the fallopian tubes to prevent eggs from traveling from the ovaries into the uterus for fertilization. The reversal procedure, also called tubal anastomosis, tries to restore the fallopian tubes’ ability to carry eggs to the uterus by either connecting the cut and fused tissue or removing the blockage in the tubes. The approach will depend on how surgeons performed the original tubal ligation.
Only about 1% of females who have undergone permanent sterilization look for ways to reverse it in order to become pregnant.
This article discusses who can get a tubal ligation reversal, how much tubal ligation reversal costs, and what to expect from the procedure.
You can talk with a doctor to find out whether you are a suitable candidate for a tubal ligation reversal. Many factors affect whether a tubal ligation reversal may allow a person to become pregnant, including:
- Age: In a study involving 128 people, 85.7% of females ages 35 years and younger became pregnant after tubal ligation reversal. In females older than 35 years, 45.5% became pregnant.
- Fertility: Females with regular periods and ovulation have the highest rate of pregnancy after tubal ligation reversal.
- Anatomy: Having 5 or more centimeters of undamaged fallopian tube tissue improves pregnancy rates among those whose tubal ligation reversal involves reconnecting the tubes.
- Smoking: Smoking lowers fertility rates, and people who smoke have an increased risk of breathing problems when under anesthesia. Smoking also affects the ability of the body to heal after surgery.
General anesthesia is necessary for the tubal ligation reversal procedure. General anesthesia comes with its own medical considerations, including:
- Reactions: If your body reacts negatively to general anesthesia, check with a doctor whether tubal ligation reversal is right for you.
- High blood pressure: The risk of stroke increases for people with hypertension when they are under general anesthesia.
- Diabetes: People with diabetes can experience complications under general anesthesia, including ketoacidosis and other medical emergencies.
If you have a male partner, it might be worth considering fertility screening for them before you commit to a tubal ligation reversal.
The average cost of tubal ligation reversal was about $8,685 in 2015. However, the reported costs range from $1,000 to $21,000, depending on several factors. These include:
- your location
- where you schedule the procedure
- your health
- extra tests your doctor might order, such as blood tests and ultrasounds
Health insurance rarely covers the costs associated with tubal ligation reversal.
A person’s age and the amount of healthy fallopian tube tissue are two important factors that influence pregnancy success rates. Success rates of tubal ligation reversal also depend largely on the method that a surgeon used to block or seal the fallopian tubes.
Tubal ligation reversal is most often successful when doctors use clips or rings for the original tubal ligation procedure. Sometimes, doctors use electrocautery, the reversal of which is less often successful.
After you schedule a tubal ligation reversal, the doctor may order blood tests and ultrasounds. They may ask you to stop taking medicines such as ibuprofen before the surgery and to stop smoking, if applicable. You might need to stop eating and drinking 8 hours before the procedure, as well.
Typically, doctors perform tubal ligation reversal procedures with robotic or laparoscopic techniques, which are both minimally invasive. Minimally invasive procedures use a smaller incision, resulting in less blood loss and quicker recovery times. It also means that you are an outpatient, so you will have the procedure, recover, and go home the same day.
During a laparoscopic tubal ligation reversal, a surgeon will insert a small scope with a camera through your belly button area to check the fallopian tubes. They will make sure that the tubes are in good shape and long enough for the procedure.
Then, the surgeon will make a small horizontal incision just above the pubic hair line. Using small tools, they will attempt to remove the cauterized or blocked fallopian tube tissue and sew the ends back together to repair it. The stitches naturally dissolve, and you will likely be able to return to your usual activities after about 2 weeks.
Some people want to become pregnant but cannot have a tubal ligation reversal. These individuals include those who underwent surgery to remove the fallopian tubes, those who cannot have surgery, and those who have too little fallopian tube tissue remaining.
In these cases, in vitro fertilization (IVF) is an alternative to tubal ligation reversal. IVF involves daily hormone injections, an egg retrieval procedure from the ovaries, semen collection, and the transferal of embryos to the uterus. Sometimes, insurance partially covers the costs of IVF.
The potential complications of tubal ligation reversal procedures include:
- Ectopic pregnancy: The risk of ectopic pregnancy is 4–8% after tubal ligation reversal. In an ectopic pregnancy, a fertilized egg implants in a fallopian tube, which is a medical emergency. It is essential to alert a doctor if you become pregnant after tubal ligation reversal so that they can monitor the pregnancy closely in the beginning.
- Anesthetic reaction: Nausea and vomiting are common reactions. However, the more serious reactions include malignant hyperthermia, which may be inherited.
- Organ damage: Although it is very rare, it is possible that the procedure might result in damage to other organs, such as your intestines.
- Infection: Surgery comes with the risk of infection. Following the healthcare team’s aftercare instructions can help minimize this risk.
- Pain: Typically, after a tubal ligation reversal procedure, doctors prescribe or recommend pain relievers to alleviate pain. This symptom should decrease as healing progresses. However, in rare cases, the pain continues to be problematic.
- Bleeding: Some people experience excessive bleeding during or after the surgery. However, this is rare.
Tubal ligation reversal is an option for people who had their tubes tied as a form of permanent birth control but have changed their mind. Tubal ligation reversal typically takes 2–3 hours and usually does not require you to stay overnight in a hospital.
Following the procedure, there is an increased risk of ectopic pregnancy inside a fallopian tube. A doctor should monitor you closely after you become pregnant in case of any problems so that they can intervene early to preserve fertility.
Research suggests that 57–84% of people who undergo tubal ligation reversal surgery will get pregnant. However, it is important to consider the risks and costs, which insurance might not cover.