TUBAL STERILIZATION REVERSAL
Tubal sterilization (tubes tied) is a common form of contraception in the United States. The objective of tubal sterilization is to create an interruption in each fallopian tube that will prevent conception.
This can be achieved by:
- applying an occlusive device (clip, ring, band) to each fallopian tube
- burning part of each fallopian tube
Sterilization reversal is a major surgical procedure performed through an abdominal incision under anesthesia (epidural or general). The re-connecting of the fallopian tubes is performed with meticulous microsurgical technique, including the use of an operating microscope and very fine sutures. Because of the delicate nature of this operation, the reversal usually takes about 3 to 4 hours. After a 23 hour hospital stay, the woman is discharged home to continue her recovery over the next 5-6 weeks. Surgical complications with sterilization reversal are rare.
The likelihood for a successful pregnancy following a reversal procedure is affected by the woman’s age, the type of sterilization procedure, and the final length of the reconnected fallopian tubes. Sterilization procedures using clips, rings, or bands have the best prognosis, while more destructive procedures such as burning have less success.
The Operation Report of the sterilization procedure will usually provide detail to determine if the reversal is possible. In properly selected candidates, the pregnancy rate seen after a sterilization reversal is quite good – usually between 40 to 80% with an associated 5 to 10% incidence of tubal (ectopic) pregnancy. Most women who conceive do so within the first 12 months following the operation.
If the operation report is not available or helpful, a diagnostic laparoscopy is recommended to visualize the fallopian tubes and to determine if they can be re-connected. When reversal is not possible, In Vitro Fertilization is the only alternative available to achieve a pregnancy.