Reversing Tubal Ligations

Conceive Magazine Excerpt By Linda Peal

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Changing your mind

Reversing Tubal Ligations - Conceive Magazine article about sterilization reversal surgery and tubal ligation reversal at Chapel Hill Tubal Reversal Center by Dr. Berger. It seemed like a good idea at the time ... but if you have been surgically sterilized and you'd now like to be pregnant again, here's what you need to know.

Surgical sterilization is the most commonly relied on method of contraception in the U.S. And the vast majority of people who opt for the surgery are satisfied with their decision. But sometimes - for a variety of reasons - women regret sterilization surgery and decide they want a second chance to be parents again (surgical sterilization is rarely performed on people who haven't had children).

Approximately 700,000 women undergo surgical sterilization each year in the U.S. It's estimated that more than 1 percent of these women will eventually opt for reversal.

For some people, in vitro fertilization is the answer, as even after surgery women's eggs can be retrieved from the ovaries. Then fertilization takes place (in vitro) in a lab petri dish rather than in vivo (in the body). But many women prefer to try and have their surgical procedures reversed so they can become pregnant the old-fashioned way, an approach they feel more comfortable with. The good news is that thanks to advances in microsurgery the chances are better than ever that reversal will be successful.

Reversing sterilization surgery in women

"Tubal ligation is meant to be a permanent method of birth control. This is what doctors who perform the procedure and counsel women about it are taught," says Gary S. Berger, M.D., reproductive surgeon and medical director of the Chapel Hill Tubal Reversal Center in Chapel Hill, North Carolina. "However, in most cases, tubal ligation can be reversed, and under the right circumstances a healthy pregnancy will be achieved." The procedure to reverse a tubal ligation is called tubal anastomosis, or tubal reanastomosis.

The success of tubal sterilization reversal depends in part on what type of surgery was originally performed. The most commonly used method of tubal ligation is called the Pomeroy procedure (a ligation-resection method). In this method, part of the fallopian tube is lifted to create a loop or knuckle. A ligature is tied around the base of the elevated portion, and the segment is removed. Within a few days, the tissue grows to cover the cut ends of the segments, which separate as the ligature dissolves. Surgeons like this procedure because it is simple, effective, and it leaves two healthy segments of fallopian tube that can be rejoined through reversal surgery later, if desired.

Another method, done with a tubal ring or clip to block the fallopian tube, is even more ideal for reversal because it damages only a small length of the tubes.

There are a few circumstances in which women's surgical sterilization are not likely to be reversible. Women with multiple site monopolar coagulation sterilization, severe endometriosis, pelvic adhesive disease and poor egg quality are not good candidates for tubal ligation reversal.

Tubal ligation reversal surgery performed by Dr. Berger is an outpatient procedure, although full recovery takes from one to two weeks. It is a microsurgical procedure usually performed under general anesthesia. The success of reversal depends in part on what type of surgery was originally performed. Besides the specific technique used for the original surgery, the success of reversal also depends on the woman's age at the time of the reversal, and the length of healthy fallopian tube remaining to be joined. Women can attempt pregnancy after their first menstrual period following surgery.

"Most couples would rather conceive naturally than undergo assisted reproductive treatment," says Dr. Berger. "Our follow-up pregnancy statistics show that tubal reversal is more successful than in vitro fertilization for most women."

More information about reversing sterilization and reversing tubal ligations

Special Report

Answers to seven important questions to find out if tubal reversal is right for you.

Call 919 968-4656 to speak with a Tubal Reversal Nurse.

Call (919) 968-4656 To Speak With a Tubal Reversal Nurse

109 Conner Drive Suite 2200, Chapel Hill, NC 27514 (919) 968-4656

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