Is female sterilisation reversible?
Re-connecting fallopian tubes
The surgery to re-connect fallopian tubes is called 'tubal reversal surgery'.
The biggest advantage of tubal reversal surgery (tubal re-anastomosis) is that once the woman has gone through the surgery, she hopefully will not need any intervention through a doctor such as medications or procedures to become pregnant. Obviously, the idea is that good old-fashioned sex will then give the couple the baby that they want. Unlike other options, there is also a very low risk of multiple pregnancy - twins occur naturally in only one in 90 pregnancies. The biggest disadvantage of tubal reversal surgery is the fact that the woman has to go through surgery and if pregnancy does not result after the tubal reversal, her main remaining option is IVF. A small disadvantage is that after she has her additional children, she will need to use contraception or get sterilised again (or her partner could have a vasectomy).
Tubal re-anastomosis surgery is performed either through a laparoscopy or a laparotomy. Under magnification from special operating lenses or a microscope, both obstructed ends of the fallopian tubes are transected (cut transversely), then the inner portion (called the muscularis) of both segments of tube and then the outer layers (called the tubal serosa) are tied together. Dye is then injected through the cervix to demonstrate potency of each re-approximated tube.
After a laparotomy, the hospital stay may be as short as one or two nights. Post-operative recovery may take three to six weeks. Recovery is much faster following laparoscopic surgery, and the woman may be able to go home within hours. However the success rate is not as great. As the procedure is rarely provided by the NHS, you’ll need to pay for it to be done privately. It can cost £4,000, though the price varies depending on where you live and the procedure itself.
The success rate of a tubal re-anastomosis depends on two major factors:
- The original surgery done for the sterilisation (the specialist will need a copy of the operative report describing the surgical method used in the original procedure) and the remaining length of the fallopian tube. Tubal re-anastomosis surgery is more successful after tubal sterilisation performed by cutting or the placement of rings or clips to block the tube.
- Adequate tubal length (pregnancy is least likely to occur in women with shortened fallopian tubes of less than 4cm).
For women with severely scarred tubes or other factors that make tubal re-anastamosis less likely to be successful, in vitro fertilisation may be a better alternative.