Tubal ligation reversal

Tubal ligation is a surgical procedure in which a woman's fallopian tubes are blocked, cut, or sealed to prevent her eggs from traveling from the ovaries into the fallopian tubes, where they could be fertilized by a sperm.

Tubal ligation is a highly effective form of birth control that is almost always permanent. Reversing a tubal ligation by reattaching the cut or sealed ends of the tubes is a major surgery.

The success of surgery to reverse a tubal ligation depends on:

• The tubal ligation method that was originally used. Hulka clip, Filshie clip, and Falope rings are successfully reversed the most often. Electrocautery is least likely to be successfully reversed.
• Time. The less time that has passed since the tubal ligation was done, the more likely it is that the reversal surgery will be successful.
• Condition of the tubes. The more the tubes are damaged, the less likely the reversal is to be successful.

Depending on the method used for tubal ligation and how much of the fallopian tube is damaged after tubal ligation, success rates for reversals are about 70% to 80%.¹

Women who have had a tubal ligation reversed have a higher-than-average risk of a fertilized egg implanting in the fallopian tube (ectopic pregnancy) rather than in the uterus.² This can become a life-threatening emergency.

Other considerations about having a tubal ligation reversed include the following:

• The surgery takes several hours, and most women are hospitalized for at least 2 days.
• The surgery can cost more than $10,000. Most insurance companies do not pay for the procedure, and it is not covered by U.S. government programs such as Medicaid or military health insurance.
• There is no guarantee that you will be able to become pregnant after having the reversal.
  • Surgeons usually refuse to perform the surgery if they think there is little chance that it will be successful.
  • About half of the women who request reversal are turned down.
  • About half of the women who have the surgery will become pregnant.

Citations

1. Speroff L, Darney PD (2005). Sterilization. In A Clinical Guide for Contraception, pp. 359–386. Philadelphia: Lippincott Williams and Wilkins.

2. Speroff L, et al. (1999). Ectopic pregnancy. In Clinical Gynecologic Endocrinology and Infertility, 6th ed., pp. 1149–1167. Philadelphia: Lippincott Williams and Wilkins.