Getting Pregnant After Tubal Reversal Surgery

Getting Pregnant After Tubal Reversal Surgery Getting Pregnant After Tubal Reversal Surgery

Thinking about a tubal reversal in order to get pregnant? While many women undergo tubal reversal surgery each year, there are important factors to consider.

Can I get pregnant after tubal ligation reversal?
A successful pregnancy after tubal ligation reversal is possible, depending on the following:  

  • Your age
  • The site where your tubes were tied
  • Underlying pelvic problems such as endometriosis and fibroid tumors
  • Ovulation function
  • Lifestyle habits and your weight
  • Qualifications of the surgeon performing tubal reversal surgery

Where were your tubes tied?
Most tubal sterilization procedures are performed in the middle of the tube. During tubal reversal surgery, stitches are placed in this muscle to rejoin the tube.

If your sterilization was done near the site where the tube joins the uterus, the chances for success with tubal reversal are less. Sterilization toward the end of the tube where the tube is larger and more delicate is less successful. Also, sterilization performed by removal of the end of the tube is not reversible. 

The most successful types of tubal reversals
Tubal reversal surgery may be most successful if your doctor used the Hulka clip for tying your tubes. The Hulka clip is the most common procedure for tying tubes. Findings show that this procedure has excellent pregnancy rates after tubal ligation reversal.

If you had Falope Rings (sometimes called bands) with precise application of the ring, the success rate for tubal reversal surgery is good. With Falope Rings, a "knuckle" of the tube is picked up and a small tight plastic ring placed over it so that the middle portion is obstructed.

First, get your operative report…
You need to get a copy of the operative report that describes the process your doctor used when tying your tubes. How much of the tube remains and the location of the sterilization are key in determining if tubal reversal surgery may let you get pregnant. 

IVF - an alternative to tubal reversal surgery
An alternative to tubal ligation reversal is in vitro fertilization (IVF). IVF is immediate with no waiting period before you can begin trying to get pregnant. For women over 35, IVF may be a successful option.

IVF may also be preferable if other factors such as ovulation problems, endometriosis and male factors interfere with normal fertility.

Are there risks with tubal reversal surgery and IVF?
With tubal ligation reversal there is a chance of ectopic pregnancy. This chance is reduced with IVF. However, IVF has an increased chance of multiple births (twins, triplets or more), and IVF may cost more than tubal reversal surgery.

Am I a good candidate for tubal reversal?
If you have the following criteria, you may be a good candidate for tubal reversal surgery:

  • At least one inch of tube coming out of your uterus. (Your doctor may determine this by using hysterosalpingography to x-ray your uterus and tubes)
  • Two and a half inches or more of residual tube with a normal fimbriated end to the tube.
  • An adequate numbers of eggs in your ovaries [determined by a simple blood test for FSH (follicle stimulating hormones)]
  • Adequate numbers and quality sperm from your male partner (or sperm donor)

How is tubal ligation reversal performed?
The concept of tubal reversal surgery is clear-cut. There is a block in the tube or piece of tube missing. An incision is made on each side of the tube just past the blockage and to the place where there is normal and open tube. The two ends are then brought together using stitches.

The most successful tubal reversal surgeries are performed under a microscope so that the edges of the tubes can be easily seen and the stitches properly placed. The tube is then tested in the operating room with blue dye to make sure it is open.

Most often the tubal reversal surgery is performed through a small incision in the lower abdomen, just below the bikini line. The procedure usually takes between 1-1/2 and 3 hours.

Who performs tubal reversal surgeries?
Some gynecologists and a few surgeons will do tubal reversal surgeries, but be sure to ask the following questions ahead of time:

  • What specialized training and credentials does the surgeon have in performing tubal ligation reversal?
  • How many years has the surgeon performed tubal reversal surgery?
  • How many tubal reversal surgeries does he/she do each year?
  • What is the pregnancy success rate following the surgeon’s tubal ligation reversals?

When can I try to get pregnant?
You may have sex and attempt to get pregnant after your second period, and in some cases, the first. Use caution as your abdomen will be tender from the surgery for a few weeks. The tubes should be sufficiently healed about 1 month after tubal reversal surgery.

If all goes well, you may get pregnant in the first month of trying. Most pregnancies are achieved in the first year after tubal ligation reversal.

Is tubal reversal surgery right for you? Talk to your doctor. So many factors must be considered with tubal ligation reversal. Trust your doctor to guide you, depending on your age and sterilization situation.

Find a local fertility specialist

Sources
  • American Congress of Obstetricians and Gynecologists: Sterilization by Laparoscopy.
  • Uptodate.com: Surgical Sterilization of Women.
  • CMAC: Female Sterilization by the Falope Ring Ligation.
  • American Congress of Obstetricians and Gynecologists: Sterilization by Laparoscopy.
  • Radiology Society of North America: Hysterosalpingography.
  • Bruce, D, Thatcher, S., Berg, B. Making a Baby.
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