Tubal Ligation Reversal – Procedure, Costs, and Risks Explained

The path to parenthood can take unforeseen turns. Perhaps you thought early on that you simply weren't ready to have children and underwent a tubectomy. However, circumstances have changed, and so have your goals. A tubal ligation reversal procedure is one such procedure that can help revive your pregnancy dream. This page discusses every detail you may want to know about the tubal ligation reversal procedure.

What Is a Tubal Ligation Reversal? 

Tubal ligation is a procedure that prevents pregnancy. Depending on the procedure type, this procedure involves tying, cutting, or burning the fallopian tubes. This prevents an egg and sperm from meeting in the fallopian tubes. As a consequence, fertilisation cannot occur; therefore, no pregnancy happens.

Following tubal ligation, the primary options for getting pregnant are the procedures known as tubal ligation reversal surgery or in-vitro fertilisation (IVF). You do not require fallopian tubes in order to get pregnant through IVF. Both options have benefits as well as drawbacks.

Tubal ligation reversal is a surgical procedure that removes the ligation in the tube. This reversal reopens or reconnects the tubes, allowing eggs and sperm to come together in order to conceive. It reverses the procedure of tubal ligation, enabling women to become pregnant again.

Tubal ligation reversal is also known as tubal sterilisation reversal, tubectomy reversal, tubal reversal, or tubal re-anastomosis.

Who Is a Suitable Fit for a Tubal Ligation Reversal Procedure?

If you have a good chance of becoming pregnant after undergoing the tubectomy reversal procedure, you can consider tubal ligation reversal; however, the possibility of success will depend on a number of factors, including:

• Age Your chances to get pregnant naturally drop with age. Younger age has been associated with increased rates of pregnancy and decreased risks of miscarriage or having a child with a congenital condition.
• Infertility Reasons Irregular cycles, pelvic scarring, uterine fibroids, or endometriosis (a condition in which the tissue lining the uterus exists outside of the uterus) can reduce your tubectomy reversal success rate.
• Partner’s Sexual Well-Being The health of your spouse's sperm can have an impact on whether you are a suitable candidate for surgery or not.
• Tubal Ligation Operation The type of tubal ligation that you have had determines the success of tubal reversal. Tubal ligation procedures, in which a doctor ties your tubes with rings or clips, are less difficult to reverse compared to electrocautery procedures, which involve the cauterising (burning) of the fallopian tubes.

How is Tubal Reversal Done?

A tubal ligation reversal procedure can be performed in a hospital or as an outpatient-based surgery. The procedure is usually performed under general anaesthesia. This will put the patient to sleep and prevent them from feeling the pain.

The surgeon operating inserts a small light scope known as a laparoscope through the navel (by making a small incision) and into the pelvis to examine the fallopian tubes and determine whether tubal reversal surgery is doable.

If the decision to perform the tubal reversal surgery is made, the surgeon will make a little surgical cut, known as a ‘bikini cut,’ at the pubic hairline. Microscopic instruments fixed to the tip of the laparoscope allow them to remove any rings or clips that were used to block the tubes and reconnect the tube ends to the uterus with small sutures (stitches).The entire procedure typically takes 2–3 hours.

Why Is Tubectomy Reversal Procedure Performed?

The tubectomy reversal procedure is performed to enable a woman to become pregnant who has already had her fallopian tubes tied up. The tubal ligation reversal procedure allows a woman whose tubes have been tied to get pregnant.

However, this surgical procedure is quite rare because success rates for IVF are now higher. Women who want to get pregnant following a tubal ligation are frequently advised to undergo IVF rather than surgical reversal. Also, certain tubal ligations are now carried out by removing the whole tube for sterilisation, eliminating the chance of reversal.

What Happens Before Tubectomy Reversal Surgery?

The doctor treating you will walk you through the surgical procedure and discuss possible risks. They will check whether you are a suitable candidate for surgery and thoroughly review your medical history. They will inquire about your previous pregnancies (if any) before tubal ligation surgery and any previous pelvic procedures.

Always inform your surgeon about any medications you are taking, including over-the-counter remedies, herbal products, or supplements.

One day preceding the surgery:

• You may be instructed to stop using ibuprofen, aspirin, naproxen, warfarin, and any additional drugs that may inhibit blood clotting.
• Consult the surgeon about which medications one should continue to take on the day of surgery.
• If one smokes, try to quit. Ask your provider for assistance in stopping.

On the morning of surgery: 

• Patients will most likely be instructed to refrain from drinking or eating anything post-midnight on the night before their procedure or for at least 8 hours before.
• Take the medications your surgeon prescribed with a little sip of water.
• The surgeon will notify patients of the time to arrive at the medical facility or clinic.

What Happens During a Tubal Ligation Reversal?

Most of the tubal reversal surgeries are done using laparoscopes. This implies that the surgeon will make multiple tiny openings in the abdomen, the largest being around half an inch long, and insert the laparoscope with a camera on its tip and small instruments to carry out the procedure. They will manage these from outside the abdomen.

During the procedure, the surgeon treating you will:

• Get an anaesthesiologist to administer general anaesthesia so that you are sleeping through the entire procedure.
• Put a tiny tube known as a urinary catheter into the bladder for collecting urine during surgery.
• To access the fallopian tubes, make one or more tiny incisions.
• During the surgery, the surgeon will determine whether the fallopian tubes should be repaired. If it is a possibility, the surgeon will proceed with the procedure. They will open the tied ends of the fallopian tubes and rejoin the sections of the fallopian tubes.
• The surgeon then will check whether or not the fallopian tubes are open by injecting a dye through the uterus. If no dye leaks out, the tubes have been properly reattached.
• Lastly, the surgeon will close the incisions using sutures beneath the skin and place a dressing around the surgical site.

What Happens After a Tubal Ligation Reversal?

Patients are likely to be able to return home on the very same day as the surgery. Some women may need to remain in the hospital longer. During that time, the doctor or medical staff will closely monitor them to make sure they are safe to return home.

Recovery from this surgery may require a week or longer. Patients may experience some pain and tenderness. The surgeon can recommend a prescription for pain medication or advise some over-the-counter pain relievers. Doctors will also provide patients with information on how to care for themselves while they are recovering, such as showering at least 48 hours after the surgery, wiping the incision with a towel, and avoiding rubbing or straining the incision for a week. The surgeon will also instruct about how long one should avoid heavy weightlifting and sexual activity after surgery.

It is important to visit the doctor for regular checkups following surgery to ensure that recovery is progressing well.

How Much Does Tubal Reversal Surgery Cost?

The cost of tubal ligation reversal in India starts at ₹50,000. The tubectomy reversal procedure cost varies between centres and hospitals based on a number of criteria. Tubal Ligation Reversal typically costs between ₹55,000 and ₹70,000.

What Are the Risks and Complications of Tubectomy Reversal?

The risks associated with tubal ligation reversal surgery are very minimal. However, like with any procedure, complications can occur, such as:

• Infection
• Bleeding or clots
• Allergic response to anaesthesia
• Surgical procedures can cause injuries to other organs.

A tubal ligation reversal may raise the likelihood of having an ectopic pregnancy, but the overall risk is quite low. An ectopic pregnancy occurs when a fertilised egg (the embryo) attaches to the fallopian tube as opposed to the uterus. An ectopic pregnancy is an urgent medical condition that calls for immediate attention from a doctor.

When Should You See Doctor?

A week or two after surgery, patients typically have a follow-up appointment with their surgeon. They will be given information on when to reach out if there are any concerns before the visit. If a woman has a positive pregnancy test, she should contact a doctor right away to be checked for a suspected tubal pregnancy.

Your doctor may recommend an X-ray dye test at some point following the procedure to ensure that the fallopian tubes are still open.

Conclusion

If, at some point, you have had a tubal ligation but want to have a child, tubal ligation reversal could be an option. Before having the surgery, the doctor treating you will determine whether you are a suitable candidate for the surgical procedure or not. Depending on your age and the condition of your fallopian tubes, IVF could be a better choice. In any case, a tubal ligation will not rule out the possibility of having a baby. Ask your provider which plan of action is most suitable for you.