MICROSURGICAL REANASTOMOSIS (TUBAL REVERSAL) OF THE
FALLOPIAN TUBE IN THE STERILIZED PATIENT
ROCKY MOUNTAIN CENTER FOR REPRODUCTIVE MEDICINE, P.C. (RMCRM)
1080 East Elizabeth Street ● Fort Collins, CO. 80524
(970) 493-6353 ● (800) 624-9035
WHAT IS A TUBAL REVERSAL?
A tubal reversal is a microsurgical procedure that rejoins the fallopian tubes in women who have
previously undergone voluntary tubal ligation (tubes tied). Microsurgical tubal reanastamosis is
the standard procedure for tubal reversals (reconnecting the fallopian tubes).
WHO SHOULD CONSIDER THIS PROCEDURE?
This procedure will only be of benefit if you and your partner are both otherwise fertile. Before
a tubal reversal can be performed, a fertility evaluation is performed to ensure that there are no
secondary causes of infertility. This could include blood work, ultrasounds, semen analysis
and/or an x-ray dye test of the uterus and fallopian tubes. Many factors determine whether or not
tubal reversal is the best option for any couple. In general, couples may choose between tubal
reversal and in vitro fertilization (IVF). We offer both tubal reversal and in vitro fertilization
(IVF). The best treatment method depends on the patient’s age, semen analysis, blood work, and
method of prior sterilization.
HOW IS A TUBAL REVERSAL PERFORMED?
If the tubal segments are favorable for surgical reconstruction, under general anesthetic, the
abdomen is opened through a small transverse (4-5 inch) incision. Next, the closed ends of the
tubes are surgically excised. Then, using a very fine suture (about the diameter of a human
hair), the tubes are reapproximated using a surgical microscope to achieve magnification of 10-
20 times. The surgery usually takes between 2- 3 hours and can be performed on an outpatient
basis or with a single overnight stay in the hospital.
WHAT ARE THE RISKS OF A TUBAL REVERSAL?
The risks of the surgery include those generally associated with having surgery and anesthesia.
The main risks associated with a tubal reversal are a fallopian tube blockage rate of
approximately 5 % and an ectopic pregnancy rate of 6%-12%. An ectopic pregnancy is a
pregnancy that develops when the fertilized egg settles and starts to grow in the fallopian tube
rather than in the uterus. In the general population, there is a 2% lifetime risk of having an
ectopic pregnancy. Following a tuba reversal, it is imperative that you contact your doctor as
soon as you have a positive pregnancy test.
MICROSURGICAL REANASTOMOSIS (TUBAL REVERSAL) OF THE
FALLOPIAN TUBE IN THE STERILIZED PATIENT
WHAT ARE THE ADVANTAGES OF A TUBAL REVERSAL?
The advantages include a high probability of uncomplicated postoperative period and rapid
return to full activity. Approximately 70% - 80% of women will become pregnant following a
tubal reversal. Success rates are affected by the woman’s age, where/how the tubes were cut, if
scar tissue has formed, and other contributing factors.
TUBAL REVERSAL VS. IVF?
With each menstrual cycle, pregnancy rates are higher with IVF. IVF is typically the treatment
of choice in older women. However, IVF is considerably more expensive than a tubal reversal.
After a tubal reversal, there is no limit to the number of times pregnancy can be attempted
through intercourse. Whereas the number of repeat IVF cycles is often limited by cost. These
issues will be discussed in detail with you at the time of your consultation.
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