Tubal Sterilization Reversal

What are tubal sterilization and tubal sterilization reversal?

Tubal sterilization, also called having your tubes tied, is very popular among women who want permanent birth control. The fallopian tubes are the tubes that carry the eggs from the ovaries to the uterus. During sex, sperm travel from the cervix, through the uterus, and into the tubes, where an egg may be fertilized. Tubal sterilization blocks a woman's fallopian tubes by cutting, tying, clipping, or burning the tubes, or by plugging the opening of the tubes. Tubal sterilization reversal is an operation to reconnect or unblock the fallopian tubes.

When is this procedure used?

If you decide that you want to become pregnant again after sterilization, having surgery to reverse tubal sterilization is one way that may make this possible. It does not always work, but it is less expensive than other procedures. If it is successful, you will not likely need any other treatments to have more children.

Another way to try to get pregnant is assisted reproduction technology (ART). When ART is done, eggs are removed from your body and fertilized with sperm in a lab. The fertilized eggs are then put into your uterus or fallopian tubes. In vitro fertilization is an example of an ART method. ART is more expensive than tubal sterilization reversal, and you may have to do it several times before you become pregnant, or it may not work at all. You will need to have the procedure again every time you want to get pregnant.

The choice between a tubal reversal and assistive reproduction methods depends on your age, the amount of damage to the tubes, cost, the quality of your partner's sperm and your eggs, and your history of pelvic infections. Reversal works best for women who are healthy and younger than their late thirties. The best results happen if it has been 10 years or less since the original surgery, and if only small sections of the middle of the tubes were damaged.

How do I prepare for this procedure?

Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest. Try to find other people to help you with your day-to-day duties.

Be sure to tell your healthcare provider what medicines you are taking, including nonprescription drugs and herbal remedies.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your wounds will heal much better if you do not smoke after the surgery.

Follow any other instructions your provider gives you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

A surgeon who is specially trained and experienced in this type surgery should perform the procedure. It is usually done by making a cut into the abdomen, while you are asleep under general anesthesia. During reversal, the damaged part of the tube is removed and the good ends are sewn back together.

What happens after the procedure?

If the surgery is successful, fertility (the ability to get pregnant) returns right away after tubal sterilization reversal. If you have sexual intercourse during the fertile times of your cycle and do not become pregnant within 3 months after reversal, you should see your healthcare provider. Your provider will determine if the fallopian tubes are able to take eggs from the ovary to the uterus.

What are the benefits?

If the surgery is successful, the chances of getting pregnant again are very high. You will probably not need any other procedures to have more babies.

What are the risks?

All surgeries have risks related to anesthesia and the surgery itself. Possible risks include allergic reactions to anesthesia medications, injury to other organs near the area, and infection after surgery. Health insurance may not cover the cost of a tubal sterilization reversal. These surgeries do not always work. If a woman becomes pregnant after this procedure, there is greater risk that the pregnancy will be in the tubes. This is called a tubal or ectopic pregnancy. If this happens, the woman will need to see a healthcare provider right away. Reversing a tubal sterilization is a difficult decision. Talk to your healthcare provider to see if this procedure is right for you.

When should I call my healthcare provider?

Call your provider right away if:

• You develop a fever over 100°F (37.8°C).
• You cannot urinate or you have pain or a burning feeling when you urinate.
• You have pain in your abdomen or your abdomen becomes swollen.
• You become short of breath or have chest pain.
• You have heavy bleeding from the vagina.

Call your provider during office hours if:

• You have questions about the procedure
• You want to make another appointment.

Written by Tony Angello, MD.
Published by RelayHealth.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.