Reversing Tubal Ligation – Risks and Chances of Future Pregnancy

Risks of Tubal Ligation Reversal

  • The main risk following a tubal ligation reversal procedure is the possibility of an ectopic pregnancy, which seems to occur quite frequently in subsequent pregnancies. After a reversal procedure a woman should be educated about this possibility and as soon as a positive pregnancy test is obtained, the first objective should be to rule out an ectopic pregnancy.
  • Tubal ligation reversal procedure is a major surgery and as such, risks associated with all other surgeries are also possible here, such as :
    • Anesthetic complications.
    • Hemorrhage – during or after surgery.
    • Injury to the surrounding organs such as the bladder and bowel.

Chances of Pregnancy after Tubal Ligation Reversal

Pregnancy rates following tubal ligation reversal are usually quite good. However, the success of ligation reversal or chances of pregnancy afterwards will depend upon certain factors, such as :

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  • Tubal Length
    • Following tubal ligation where a part of the fallopian tube has been cut, there will be two stumps left – one attached to the uterus and the other lying separately.
    • During a reversal operation, the two ends of the stumps are joined together again.
    • The shorter the stumps, lesser is the chance of pregnancy following re-anastomosis.
    • However, while the length of the proximal stump (attached to the uterus) can be determined by a dye test, it may not always be possible to determine the length of the separated end of the tube, so the success of the operation cannot always be predicted definitely.
  • Type of Tubal Ligation
    • Tubes that have been blocked with a clip or ring cause less damage and women who have undergone this method of tubal ligation have better chances of pregnancy after reversal than tubes that have been cut or burned.
    • It may not be advisable to go for reversal in those women where a ligation procedure has removed a large part of the tube.
    • Successful pregnancies have been achieved following reversal after newer techniques such as Essure or Adiana implant, but more data is required regarding long-term statistics.
  • Tubal Diameter
    • The remaining ends of the two portions of the tube that are to be reanastomosed should ideally be of the same diameter so that they can be joined together smoothly.
    • This will ensure better chances of pregnancy and possibly lesser chances of ectopic pregnancy.
  • Age
    • Younger women have better chances of pregnancy following tubal reversal.
    • Women over the age of 38 may not be suitable candidates for this procedure.
  • Semen Analysis
    • It is advisable to get the male partner’s semen analysis done to be sure that the sperm count, motility and sperm quality is viable for fertilization.
    • This ensures that the pregnancy will not be hindered due to some problem with the male partner.
  • Pelvic Pathology
    Any pelvic pathology or abnormal ovarian function that may make pregnancy difficult even after tubal reversal procedure has to be ruled out.
  • Other Considerations
    Sometimes, even after all conditions seem favorable, pregnancy may not occur following a tubal ligation reversal procedure. In case pregnancy does not occur after a reversal procedure the only other option remaining – other than adoption – is IVF (in vitro fertilization).

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