RISKS OF TUBAL LIGATION REVERSAL
What is Tubal Ligation
Tubal ligation, commonly known as “having your tubes tied” is the process of cutting or blocking the fallopian tubes to prevent pregnancy. The fallopian tubes connect the ovaries to the uterus. A woman who has this surgery can no longer get pregnant until it is reversed.
Overview of Tubal Ligation Reversal
Tubal Ligation Reversal is a procedure to restore the fertility of a woman who has gone through Tubal Ligation. During the reversal process, the blocked segments of the fallopian tube are reconnected to the remainder of the tube. This allows the egg to again move through the tubes and the sperm to travel up the fallopian tube to join the egg.
Tubal ligation procedures that cause the least amount of damage to the fallopian tubes are the most likely to allow a successful tubal ligation reversal. Examples include sterilization with tubal clips or rings. Procedures that cause scarring to seal off the fallopian tubes generally aren’t reversible.
A tubal Ligation Reversal procedure may allow a woman to get pregnant without further medical help. It is not appropriate for everyone. For a successful reversal, your doctor will determine if it is right for you based on several factors such as:
- Your age and Body Mass Index
- The type of tubal ligation you have had
- The extent of damage to your fallopian tubes
- Quality of the egg and the sperm
- Remaining tubal length
In most cases the technique is an outpatient or short-stay procedure using a small abdominal incision and micro-surgical techniques to restore the connection between the interrupted tubal segments. As with any surgery, there are risks involved including infection, poor tissue healing, further damage to the fallopian tubes, uterus or ovaries as well as other surrounding tissues, and anaesthetic complications. Furthermore, one must consider the post-operative recovery period and time off from work, usually relatively minimal but possibly prolonged. Each patient must determine these risks with her surgeon based on her individual circumstance. Keep in mind that the tubes will always be somewhat damaged following any type of surgery and the risk of ectopic (tubal) pregnancy is ever present. If a reversal is successful there is also the need to again consider post-partum contraception options.
Risks of tubal ligation reversal may include –
- Inability to get pregnant even after the reversal. This varies greatly depending on the woman’s age and other factors.
- Scarring of the fallopian tubes
- Injury to nearby organs
- Anaesthesia complications
- Ectopic pregnancy – where the fertilized egg implants itself in the walls of the fallopian tube instead of the uterus.
Which is the best choice: IVF or tubal reversal?
Though it is hard to predict the odds of pregnancy after the reversal, women under the age of 35 have better success rates than older women. In cases of a failed tubal ligation reversal, In-vitro fertilization (IVF) may be an alternate option that can help you get pregnant
Obviously the decision between IVF and tubal reversal is difficult. In addition to costs and success rates, one should also consider the presence of other potential infertility problems. How many more children are desired? If multiple children are desired and the woman is young, tubal reversal is perhaps a better choice. If only one more child is desired and the woman is older than 35 years of age, perhaps IVF is the best choice.
Each couple facing this decision must be assessed and counselled individually to ensure selection of the treatment option best suited to them.