Sunday, December 20, 2009

Can Tubal Ligation Be Reversed?


If you have your tubes tied can you have them untied to get pregnant? How is the procedure done and how long does it take and what are the chances of getting pregnant?

Thank you!


The term "tied" is actually a misnomer. Basically, all tubal ligation procedures damage a portion of the tube causing the canal to be blocked off. There are various methods and the ability to repair them varies depending on the method. The methods are:

Post-partum tubal ligation (tubes are tied in two places and the tube removed in between). The ends are then cauterized.

Laparoscopic tubal ligation done through a scope. The tubes can be burned, clipped or a ring placed. The clip method yields the best reversal and burning and cutting the least successful reversal.

In addition, there has to be sufficient normal tube present for the tube to function (4 cms). If the fimbria is damaged (fimbriectomy) then this is absolutely not reversable. Most physician do a laparoscopy first to evaluate whether or not the tubes can be reversed before doing the reversal procedure.

Because the tubes are damaged, the chances for pregnancy are reduced and the chances depend on your age. As an infertility specialist and gynecologic surgeon, I can perform microscopic tubal reconstruction. Regardless of age, a complete evaluation is done to eliminate the possibility of other infertility factors. Some of those factors may include: maternal age, surgical risk, and ectopic pregnancy risk. See my page on "Microscopic Tubal Reconstruction".

I do not recommend tubal reversal surgery in patients over the age of 35.

A viable alternative is In Vitro Fertilization, which has a much higher chance of pregnancy per month of trying. Most fertility specialists do not do reversal anymore for this reason. For the same cost, IVF is better and is not a surgery, which means less risk. Cost wise, both are approximately the same and range from $8000-15,000. I hope this answers your question.


Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.

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