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Tubal Reversal – Are You a Candidate?

Tubal ligation, or “having your tubes tied”, is one of the most popular forms of sterilization in the United States. Slightly greater than 25 percent of women who are of childbearing age opt for this method to prevent pregnancy.

Tubal ligation is a relatively simple procedure in which a small incision is made into the abdominal area in order to access the fallopian tubes. The tubes are then clipped, sealed, cut, or tied, preventing pregnancy from occurring right away. It’s a highly safe and effective way to stop the egg and sperm from meeting, and there are minimal future side effects, beyond the usual risks surrounding surgery.

Although considered a permanent form of pregnancy prevention, it can fail 1-2% of the time but also can be reversed in the future. There are many reasons a woman may opt for the procedure, then later, reconsider and pursue pregnancy. Situations and relationships change, and the decision to grow your family may change accordingly. In fact, about 1 in 15 women do reconsider their decision. For those women who have had a tubal ligation and have decided to investigate undergoing a tubal reversal, here are some things you should consider.

 

What Makes You a Good Candidate for Tubal Reversal Procedure

If you are a woman who wants to undergo a tubal reversal procedure in order to open, or re-attach, the fallopian tubes, you must first determine your eligibility. In other words, there are certain factors that may prove the odds are not in your favor, or the procedure simply won’t work.

 

Age

As in most issues concerning fertility, your age plays a central role in the success of your treatment. For those women under 35, the success rate is high-up to 70 percent have a successful outcome. For those women over 35, the success rate dips to 50 percent, and for women 40 and over the live birth rate drops to 20-30 percent.

There may be other age-related factors to consider that detract from your potential for success, for instance diminished egg reserve, problems with ovulation, hormonal imbalances, or early menopause. Sometimes diminished ovarian reserve affects younger women. Your doctor will thoroughly assess your ovarian reserve prior to moving forward with your tubal reversal.

 

The Type of Tubal Ligation Procedure Performed

Most tubal ligations can be reversed, as long as the remaining tubes are greater than 4 cm in length. However, the method used to reverse your tubal ligation depends on the type of surgery performed. Obtaining a record of your tubal ligation procedure is helpful to your physician in the reversal process.

 

Your Overall and Reproductive Health

Obviously, as with any surgical procedure, your overall health will determine your potential for risk, as well as the success of your outcome. If you are overweight, with a body mass index (BMI) greater than 27, the procedure will be more difficult. Odds are lower for those with a BMI between 27and 30, and for women whose BMI is greater than 30 the procedure may be considered on an individual basis.

Additionally, if you’ve had any type of abdominal or gynecological surgeries there is a possibility you’ll have some scarring, which can interfere with the tubal reversal procedure. Women who have had surgeries for endometriosis, fibroids, or other procedures impacting their reproductive region can have significant scar tissue. Those who have had infections or pelvic inflammatory disease, may have experienced scarring as well.

 

What Rules You Out as a Candidate for Tubal Reversal

Unfortunately, not everyone is a candidate for tubal reversal surgery. Obviously your doctor will have the final word, however some factors that may rule out your eligibility are:

 

  • Your age is an important consideration for tubal reversal as well as other variables. If your partner does not have any sperm and needs a testicular biopsy, you will need IVF treatment anyway and surgery will not be indicated or helpful.

 

  • The type of tubal ligation you had is important. If they removed the end of your tubes called fimbria, then reversal cannot be done.

 

  • Your health plays a significant role in any surgical procedure, including tubal reversal. If you are at high risk for surgery, then reversal may not be best option for you. Also, pregnancy may pose a risk as well even if you do IVF treatment. You need an evaluation in such circumstances and in some cases using a gestational carrier (surrogate mother) may be the best option.

 

Exploring Other Options

Should you and your physician determine you are not a candidate for tubal reversal, there’s still hope to expand your family. Other fertility treatments, such as IVF, third-party donation and surrogacy are some of the ways you can realize your desire to have a child. Ultimately, realizing your goal of a healthy child relies on your knowledge, expectations, and the relationship you have with your fertility team.