What Is a Tubal Ligation Reversal?
A tubal ligation reversal, or tubal reanastamosis, is a surgical procedure to reverse a tubal ligation, sometimes referred to as “tied tubes.” About one million women in the United States undergo elective tubal ligation procedures each year, and many later seek the assistance of a surgeon to reverse them. Our fertility doctors repair and restore a woman’s fallopian tubes so that she will be able to again become pregnant. Once their fallopian tubes are corrected, their uterus will work naturally again, so they don't have to take fertility medication. The male sperm will be able to move through the uterus, uninhibited, naturally joining with an unfertilized egg.
Who Is a Candidate?
A woman may need to have a hysterosalpingogram or a laparoscopy performed to determine the feasibility of success before a reversal can even be attempted. Reversal success rates are dependent upon several factors, including:
- A woman’s reproductive age
- The location and type of tubal ligation
- How long ago the procedure was done
- The final tubal length after reversal
The best candidates for tubal reversal are women under age 31 who have had falope ring or clip tubal ligations involving the portion of the tubes closest to the uterus and who have no known infertility factors. Less than five percent of women with tubal ligations have damage that cannot be repaired.
How Does It Compare to IVF?
With steady improvements in the pregnancy rates resulting from assisted reproduction, patients now have a non-surgical option for achieving pregnancy after a tubal ligation through in vitro fertilization, which transfers embryos directly into the uterus for implantation. In nearly all tubal ligation cases, IVF offers the best chances for pregnancy success. The risk factors, benefits, and success rates of each procedure are outlined below:
Benefits of Tubal Ligation Reversal Surgery
The main benefit of performing this surgery is that the patient is back to normal. She can become pregnant the old-fashioned way, through natural intercourse. She doesn't have to continue with fertility medications or weekly check-ups with a fertility specialist. She also doesn't have to worry about having multiple children. Now it's still possible to have twins and triplets, the chances are limited with the tubal reversal. After she goes through the surgery, she'll just need to be conscience of using contraception unless she wants to continue having more children.
How Much Does a Tubal Reversal Cost?
While many insurance plans do not cover reverse sterilization or infertility treatments, the majority will cover the diagnostic tests that help determine which treatment method is right for each patient.
Keep in mind that although the cost of a tubal reversal is fixed, the fees for facilities and anesthesia vary significantly, many times exceeding the cost of IVF. Due to these and other varying factors, tubal reversal cost can range from $8,500 to $18,000.
For women without infertility treatment coverage, the Fertility Center offers IVF packages starting at $10,000. This includes all treatment procedures, ultrasounds and labs, micromanipulation, cryopreservation, anesthesia and facility fees. Medication costs are additional. For qualified patients, we also have a Bring Home a Baby Money Back Guarantee program.
Regardless of the procedure, financing is available. The Fertility Center guides each patient in choosing the option that best fits her budget.
Tubal Status Complications
When a woman goes through tubal ligation, her fallopian tubes are cut, cauterized and tied together. The length of these cauterized ends of the tubes matters when considering tubal reversal surgery. The longer the cauterized ends of the tubes are, the higher the change for a successful reversal and pregnancy, but the shorter the tubes are, the lower the chances for pregnancy. We can't know how long the tubes are without surgery. We can use a hysterosalpingogram to know the length of the proximal tube, but it won't tell us the length of the distal tube.
Another potential problem can be if the fimbriated end of the cauterized tubes are damaged or have been removed. The fimbria are the fluffy and delicate ends of the tubes that "pick up" the egg during ovulation when the potential egg is released from the ovary. If the fimbria is damaged, the chances of a successful pregnancy are low.
If all fertility signs are good, long tubal ends, working fimbria, good sperm from a male partner, the success rates for tubal reversal surgery are greater than 75% within the first year! This means that within the first year of trying with their partners, more than 75% of women with long tube ends, good fimbria, and good sperm will find a successful pregnancy!