Tubal Litigation Reversal

What is a tubal litigation reversal?

A tubal litigation reversal is a procedure designed to reduce a tubal litigation—a procedure that blocks or cuts the fallopian tube to prevent a woman from getting pregnant. The original tubal litigation surgery is commonly referred to as “having your tubes tied.”

When a woman undergoes a tubal litigation reversal, the severed or blocked portions of the fallopian tube are reconnected in hopes of creating a pathway for eggs to move through the fallopian tube and sperm to travel to meet the egg.

Tubal litigations that cause sterilization with tubal clips or rings are most likely to result in a successful tubal litigation reversal as they cause least amount of damage to the fallopian tubes. Procedures that call on scarring, such as ones using the Essure or Adiana systems, to seal the fallopian tubes, are rarely reversible.

Why do women get a tubal litigation reversal?

Tubal litigation reversals are performed for one purpose—to restore fertility in hopes of getting pregnant. The reasons that cause a woman to want to reverse her tubal litigation are vast and personal.

Who can get a tubal litigation reversal?

Many factors determine whether or not a woman is a candidate for a successful tubal litigation reversal. Your doctor will evaluate many factors, including:

  • The original procedure used to tie the tubes
  • Age
  • Body mass index
  • Extent of damage to fallopian tubes
  • Remaining length of fallopian tubes
  • Additional fertility factors, include egg and sperm quality
  • Overall health of your reproductive organs (ovaries, fallopian tubes, uterus)

Additionally, your doctor will ask you questions to evaluate your prognosis of success with a tubal litigation reversal, such as:

  • When did you have your tubal litigation procedure performed and what method was used?
  • Have you ever been pregnant? Was it a healthy pregnancy?
  • Have you ever had surgery for fibroids, endometriosis, pelvic inflammatory disease (PID) or another gynecological disorder? (Scar tissue from these types of surgeries can affect the success of a tubal litigation reversal.)

A tubal litigation reversal is most suited for women who had a minimal part of the fallopian tube removed and had her tubes blocked using rings or clips. According to some healthcare professionals, the ideal candidate for a tubal litigation reversal is a woman under 40, whose tubes were tied directly following having a baby. This procedure is called postpartum tubal litigation.

What happens before the tubal litigation procedure?

Before having your tubal litigation reversed, you and your partner will likely be advised to undergo a complete physical exam. This will inform your doctor of any other issues that may prevent you from getting pregnant, even if the reversal is successful. You may also undergo imaging or blood tests to evaluate the health of your ovaries.

Another pre-procedure test that will be conducted is the hysterosalpingogram (HSG), which evaluates the function and length of the remaining fallopian tube. The HSG test may be done using saline and air, dye and x-rays or via ultrasound. Your partner may also be tested for sperm count and have a sperm analysis performed to further evaluate fertility.

How is a tubal litigation reversal done?

A doctor at a hospital or outpatient center performs the tubal litigation procedure. The process takes two to three hours and you will not need to stay overnight. You’ll be put under general anesthesia, meaning you will be fully asleep during the process.

The doctor uses a small light up scope called a laparoscope inserted through the bellybutton into the pelvis area to view the fallopian tubes and determine if the surgery is possible. If everything checks out, the surgeon makes a thin surgical cut near the public hairline called a bikini cut. Small instruments mounted on the laparoscope allow the surgeon to remove any clips or rings used in the tubal litigation and use small stiches to re-fuse the tubes to the uterus.

What is recovery like for a tubal litigation reversal?

A tubal litigation reversal is major abdominal surgery. It is more invasive and takes more recovery time than a tubal litigation. You will likely be released 2-4 hours following surgery and prescribed painkillers for the recovery. Most women are able to resume normal activity within roughly 2 weeks.

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What are the chances of getting pregnant after a tubal litigation reversal?

If you have adequate length and health of the fallopian tubes and no other fertility issues are present in you or your partner, you have a high chance of getting pregnant following a tubal litigation reversal. However, the procedure does not work for everyone and factors like age and lifestyle can influence how successful the procedure is for you. Generally, your chance of getting pregnant after a tubal litigation reversal ranges from 40-85%. Most women who will have a successful pregnancy will do so within the first year.