How to Reverse a Tubal Ligation

Three Parts:Getting Approval from DoctorsPreparing for a Tubal Ligation ReversalUnderstanding the Risks

Tubal ligation is a type of surgery that closes or blocks women's Fallopian tubes so their eggs can't enter the uterus and get fertilized by sperm. It's meant to be a permanent form of female sterilization and birth control. However, sometimes people change their minds, so tubal ligation reversal surgery reopens, unties or reconnects women's Fallopian tubes so they can become pregnant. Your age, type of previous tubal ligation procedure and overall health dictate if tubal reversal is right for you. Surgical success rates can be as high as 80% or as low as 40% depending on your situation.[1]

Part 1
Getting Approval from Doctors

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    Don't wait too long. When life circumstances change and you're convinced you want to reverse a tubal ligation, then time is of the essence. In general, the less amount of time that's passed since your "tubes were tied," the more likely the reversal surgery will be successful.[2] Furthermore, the older you are, the less likely the reversal surgery will be successful.
    • Call your doctor and "get the ball rolling" on a reverse tubal ligation as soon as you and your partner decide that it's the right decision.
    • Women who get tubal ligations in their 20s are much more likely to regret it later in their lives and want reversal surgeries.
    • Women who get divorces and quickly remarry are more likely to want to reverse their tubal ligations.
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    Consult with your doctor. Once you've made the decision for the reversal, consult your doctor on the pros and cons, and whether your particular situation is appropriate for such surgery. A tubal ligation reversal isn't appropriate for everyone, so your doctor will want to know your age, body mass index (BMI), overall health and your type of tubal ligation.[3]
    • If your doctor thinks your age and health is not only appropriate for having a reversal surgery, but also for getting pregnant, then they will likely refer you to your gynecologist for a more detailed examination.
    • The best candidates for tubal reversal surgery tend to be women who are younger than 40 years old and had a tubal ligation procedure immediately after childbirth — known as a postpartum tubal ligation.
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    Get a thorough gynecological exam. If your health and age are appropriate, your gynecologist will want to confirm the type of tubal ligation procedure you had, examine the extent of damage to your Fallopian tubes and check the remaining tubal length.[4] And if you're keen on getting pregnant quickly, the doctor may also check other fertility factors, such as your egg quality.
    • There are many types of tubal ligation procedures, but methods that use clips and rings (Hulka clip, Filshie clip, Falope rings) are most successfully reversed.[5] Conversely, electrocautery (burning methods) are least likely to be reversed.
    • Women who have only small sections of their Fallopian tubes removed are better candidates for successful reversal surgery — the more tube remaining the better.
    • Previous gynecological surgeries for endometriosis, fibroids or pelvic inflammatory disease can cause scar tissue and reduce the success rate of tubal reversal procedures.
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    Consider alternatives to tubal ligation reversal. If your age, physical health and/or condition of your Fallopian tubes isn't ideal for a reverse tubal ligation procedure, then you should consider some alternatives, such as IVF, if you still want to get pregnant. In vitro fertilization (IVF) is the combining of an egg from your ovary and sperm from your partner in a laboratory dish and then implantation into your uterus.[6]
    • Pregnancy via IVF doesn't require tubal ligation reversal or even healthy Fallopian tubes — just healthy eggs and uterus.
    • IVF tends to cost more than tubal ligation reversal surgery, usually between $12,000 - $17,000 USD.[7]
    • Adoption and having a surrogate carry your baby are other alternatives to having a child if your Fallopian tubes can't be restored to normal function.

Part 2
Preparing for a Tubal Ligation Reversal

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    Get a referral to a reputable surgeon. Your gynecologist may be the best person to operate on you if they're qualified, but you may have to (or want to) look for someone else. Research surgeons online that perform tubal reversal procedures and/or get a referral from your family doctor or gynecologist. Search for a surgeon's ratings, recommendations and legal history on state medical board websites. Get the surgeon's credentials and ask what kind of reversal procedures they specialize in.
    • You'll need anesthesia for the procedure, so ask who the anesthesiologist might be and the credentials of other staff members.
    • Surgeons often refuse to operate if they think there is little chance of a successful reversal — about 50% of women who request reversal surgeries are turned down.[8]
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    Understand the cost. Make sure you clearly understand the cost. Reversal surgeries can cost more than $10,000 USD and most insurance policies and government programs (Medicaid or military coverage) don't pay for them, nor will they reimburse you.[9] Realize that the total cost includes separate fees for the surgeon, the anesthesiologist and the hospital / private clinic, although the surgeon's secretary or assistant will typically charge you one amount and then distribute it to the other parties.
    • Try asking for a discount if you are experiencing economic hardship. There's no harm in politely asking, just don't demand it.
    • Ask about a referral system. Some doctors pay fees (kick backs) if you refer other patients to them. This can help to offset your costs if you're happy with the outcome of the surgery and want to recommend it to friends or family.
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    Book your procedure in the hospital or outpatient clinic. Depending on what surgeon you choose and their affiliations, you might have your procedure in a local hospital or a private clinic. Regardless of where it's performed, reversal surgeries usually take several hours and most women need to stay in the hospital or clinic for at least 2 days to recover enough to go home.[10]
    • Remember that once you pay for the procedure beforehand, you likely won't get any refund if you miss your appointment.
    • To minimize the time lost from work, consider booking your surgery on a Friday afternoon and then spend the weekend recovering.
    • Before your appointment, remember not to eat. Surgery with anesthesia should be performed on an empty stomach.
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    Understand the procedure. Once the anesthesia takes affect, the surgeon will make a small incision in your lower abdomen (mini-laparotomy) to expose your uterus, Fallopian tubes and ovaries, and insert a small lighted tube (laparoscope) with a light and cutting device on the end of it.[11] Then he/she will remove any clips / rings used to block your Fallopian tubes and attempt to repair them with absorbable stitches.
    • The surgeon may not be able to reattach one or both of your Fallopian tubes if too much was removed or damaged during the initial tubal ligation.
    • Usually a small "bikini cut" is made near your pubic hair area so the scar can be covered up with panties and bathing suits.
    • The surgery usually takes between 2-3 hours and most women are hospitalized for at least 2 days — although micro-surgical techniques in some cases can allow the woman to go home on the same day.
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    Prepare to recover after the surgery. Once you get home from the hospital / clinic, you'll probably still need at least a few days (perhaps a week) to heal more before going back to work — depending on what you do for employment. Don't use aspirin for pain relief after the surgery, since it may promote internal bleeding.[12]
    • You may bathe starting 48 hours after the surgery, but don't strain or rub the incision for 1 week.
    • Carefully dry your incision area after bathing by gently patting it with a soft, clean towel. The stitches will dissolve and won't need to be removed.
    • Avoid strenuous lifting, lots of turning or twisting and sexual relations for about 2 weeks to be on the safe side.
    • Resume your normal daily activities slowly and only as you begin to feel better.

Part 3
Understanding the Risks

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    Look out for an allergic reaction to anesthesia. As with any major surgery that involves anesthesia, there's always a risk of an allergic and potentially life-threatening reaction.[13] Allergic reactions can be mild and involve just a skin rash and itching, or severe and involve difficulty breathing from a closed air passage. Your anesthesiologist will try to screen you for it and watch you closely on the table, but if you've never had it before, it's impossible to anticipate your reaction.
    • If you're allergic you'll likely react right away while you're being operated on with uneven breathing or shortness of breath. Your anesthesiologist can reduce the dosage or change to a different mixture to help.
    • This most severe type of allergic reaction is known as anaphylaxis, which can restrict breathing and lead to death — it occurs in about 1 in 5,000 surgeries.[14]
    • If you notice a skin rash, itchiness, general numbness or nausea that lasts for a few days, then you might be allergic to anesthesia and should tell your doctor for future considerations.
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    Watch out for infection. Another risk factor for any invasive surgery, but especially one as major as a tubal ligation reversal, is infection.[15] Modern sterile surgical methods with small incisions rarely lead to internal infections, but it's important to keep your incision clean so it doesn't get infected. Once you get home from the hospital, apply antibacterial cream to your incision 2-3x daily to help prevent it from infection.
    • Signs of an external infection include localized swelling, tenderness, skin redness and leaking of puss mixed with some blood.
    • Signs of an internal infection that's spread to your blood include a high fever, general abdominal / pelvic pain, nausea, fatigue and confusion.
    • Make a follow-up appointment with your doctor about a week after your procedure to make sure your incision is healing and there's no signs of infection or other complications
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    Be alert to an ectopic pregnancy. Women who have tubal reversal procedures have an increased risk of an ectopic pregnancy, which is a life-threatening condition that entails a fertilized egg implanting and growing outside your uterus — usually in a Fallopian tube.[16] An ectopic pregnancy requires immediate medical attention and removal of the egg from the Fallopian tube.
    • Early signs of an ectopic pregnancy are similar to a normal pregnancy — missed period, breast tenderness, nausea, positive pregnancy test.[17]
    • Abnormal symptoms that indicate there's a problem include: vaginal bleeding, abdominal / pelvic pain, lightheadedness and fainting.
    • If symptoms persist or quickly get worse, see your doctor immediately.


  • Be aware that some types of female sterilization procedures, such as the Essure system, are not considered reversible by later surgeries.
  • You'll need a test called a hysterosalpingogram in order to check the length and function of your Fallopian tubes.
  • Tubal reversal is considered a major invasive surgery and takes longer to perform than the initial tube-tying procedure.
  • About 50% of women who have reversal surgery will become pregnant, usually within the first year of trying.

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Categories: Reproductive Health