Tubal ligation reversal is a surgery that reopens your fallopian tubes after tubal ligation (having your tubes tied). It may be an option to restore your fertility if you decide you want to have a baby. Your healthcare provider can advise you on whether this surgery is right for you. They can talk you through alternatives like IVF if reversal isn’t possible.
Tubal ligation (sometimes called “having your tubes tied”) is an operation that prevents pregnancy by tying, cutting or burning your fallopian tubes. A tubal ligation blocks your fallopian tubes so that an egg and a sperm can’t meet. As a result, fertilization can’t take place.
After tubal ligation, the only options for becoming pregnant is either tubal ligation reversal surgery or in vitro fertilization (IVF). You don’t need fallopian tubes to become pregnant with IVF. Both options have their pros and cons.
Tubal ligation reversal is surgery to undo a tubal ligation. A tubal ligation reversal reconnects or reopens your tubes, creating a passageway for eggs and sperm to unite so that conception can occur. It reverses a tubal ligation, allowing you to become pregnant again.
Tubal ligation reversal is also called tubal reversal, tubal sterilization reversal and tubal reanastomosis.
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You’re a good candidate for tubal ligation reversal if there’s a good chance you can become pregnant after surgery. The likelihood of success depends on multiple factors, including:
If most or all of your fallopian tube has been removed or the end of the tube cut off, reversal isn’t possible. Essure® and Adiana® are sterilization devices previously marketed as non-surgical alternatives to tubal ligation. They involved inserting devices through your vagina and into your fallopian tubes, creating a blockage to prevent sperm from reaching an egg. Both have been taken off the market (Adiana® in 2012 and Essure® in 2019). The effects of these devices on your fallopian tubes can’t be reversed.
See your healthcare provider if you’ve used these products and wish to become pregnant.
Your healthcare provider will explain the procedure and review any risks. They’ll perform the following to ensure you’re a good candidate for surgery:
It would be helpful if you brought a copy of the report from your tubal ligation operation to your first consult with your fertility doctor. If your tubes were removed, bring the pathology report, too.
To improve your chances of having a healthy pregnancy:
Tubal ligation reversal surgery lasts about two to three hours and takes place in a hospital. You’ll be able to go home the day of your operation.
The procedure your healthcare provider uses will determine what happens during surgery. With mini-laparotomy, your provider makes a single 2-inch side to side incision just below your bikini line and performs the surgery through the cut using an operating microscope. With robotic-assisted laparoscopy, your provider operates a console that controls the robotic arms that perform surgery through several small incisions in your abdomen.
During surgery, your healthcare provider will:
You’ll be asleep during the procedure, which means you won’t feel any pain. Your healthcare provider will prescribe pain medications after surgery to ensure that you’re comfortable once the anesthesia wears off. After the procedure, you’ll experience soreness at the surgery site.
You’ll remain in the hospital for approximately two hours after surgery. In that time, your healthcare provider or care team will monitor you to ensure you’re safe to go home. Before you leave the hospital, your provider will give you medicine for pain, nausea or vomiting, as needed. They’ll also provide instructions on how to take care of yourself during recovery.
You may feel sleepy or groggy for several hours after surgery as the anesthetic wears off. To be safe, you must have a friend or family member drive you home.
The biggest advantage of surgery is that you can try to get pregnant every month and get pregnant more than once without any other fertility treatments.
The risks with tubal ligation reversal are very low. As with any operation, however, complications can occur, including:
A tubal ligation reversal can increase your risk of ectopic pregnancy, but your overall risk is still very low. Ectopic pregnancies occur in 2% to 7% of pregnancies following a tubal reversal. With an ectopic pregnancy, a fertilized egg (embryo) implants in your fallopian tube instead of in your uterus. An ectopic pregnancy is a medical emergency that requires your healthcare provider’s attention.
The pregnancy rate following tubal ligation reversal varies from 50% to 80%. Successful surgery depends on many of the same factors that shape whether you’re a good candidate for surgery, like your age and the length of your fallopian tubes following your tubal ligation. Your surgeon’s skill will also impact your surgery’s success.
Most people resume normal activities within a week or two. Check with your fertility doctor to be sure.
Most pregnancies happen within the first year or two following tubal reversal. You’ll need to wait two menstrual cycles before trying to get pregnant.
IVF is the other option for getting pregnant after a tubal ligation. It also has a high pregnancy rate but doesn’t involve any surgery. The disadvantages are that it involves many complex steps. For example, it requires about 10 days of injecting fertility drugs and several office visits for monitoring with ultrasounds and blood work.
Your fertility doctor may recommend IVF if you’re not a good candidate for tubal reversal, or you may choose IVF if you prefer that to surgery.
A follow-up appointment will be scheduled with your surgeon a week or two following surgery. You’ll receive instructions on when to call if you have any problems before that visit. You should call as soon as you have a positive pregnancy test so you can be evaluated for a possible tubal pregnancy. Your provider may schedule an x-ray dye test (HSG) a few months after your procedure to make sure your fallopian tubes remain open.
A note from Cleveland Clinic
Tubal ligation reversal may be an option if you’ve had a tubal ligation but would now like to try for a baby. Before proceeding with surgery, your healthcare provider will make sure you’re a good candidate for the procedure. Depending on factors like your age and the condition of your fallopian tubes, IVF may be a better option. Either way, a tubal ligation doesn’t have to mean you can’t have a baby. Ask your provider about what course of action is best for you.
Last reviewed by a Cleveland Clinic medical professional on 09/01/2022.
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