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Tubal Reversal: One or Both Tubes?

It is considered ideal if both tubes are re-connected (bilateral re-anastomosis) during tubal reversal surgery, but in some cases this may not be possible. Patients with a history of unilateral salpingectomy (removal of one of the fallopian tubes), one sided tubal damage or with a blocked tube, very short tubal segment, unilateral salpingo-oophorectomy (removal of the tube and ovary on the same side) and dense pelvic adhesions followed by tubal ligation, may not be candidates for bilateral (both sides) tubal reversal.

In such cases, unilateral (single sided) tubal reversal is performed. Based on the medical literature, the pregnancy rates are similar in patients who had tubal reversal of one or both tubes. It is interesting that if ovulation occurs from the ovary without the fallopian tube, pregnancy is still possible because the other healthy tube can pick up the egg from the pelvis that can result in a healthy pregnancy. One sided tubal reversal is considered a viable option for women who are considering expansion of their family.

Overall, the success rates with tubal reversal also depend on the reproductive age, sperm parameters, medical problems and the presence of a normal uterine cavity (endometrium or endometrial cavity) in addition to a healthy and open tube. In some cases, In Vitro Fertilization (IVF) may be a better option for women with a single fallopian tube along with the presence of other fertility problems. Dr. Bayrak recommends that all options be discussed with patients who are candidates for tubal reversal, along with reproductive age associated success rates and some of the risks, benefits, alternatives associated with each option.