Having children is a major decision in a woman’s life. So too is a tubal ligation — or “having your tubes tied” — to prevent yourself from having children.
But what happens if you change your mind after this surgery? In most cases, you have options, including reversing the tubal ligation, says surgeon and fertility expert Jeffrey M. Goldberg, MD.
If you had a tubal ligation but now have decided you want to have more children, you are far from alone.
“Anywhere from 5 to 20 percent of women have expressed regrets about having a tubal ligation,” Dr. Goldberg says. “In many cases, that’s because of a change in circumstances, such as remarrying and wanting to have children with a new partner.”
If you do change your mind, surgeons likely can help. Tubal ligations performed during or after a birth can almost always be successfully reversed. That’s true even years after the original procedure.
Only one type of original procedure — hysteroscopic tubal ligation — is irreversible. If you had this type of surgery, tubal reversal is not an option.
Tubal ligations performed during or after a birth can almost always be successfully reversed.
There are several techniques for performing tubal reversal. Dr. Goldberg prefers a minilaparotomy — a minimally invasive outpatient procedure.
Minilaparotomy requires an incision of only 2 inches and has the same success rates as more invasive techniques. It also offers a quicker recovery and less expense. Risks are minimal, including a slightly higher risk of a tubal pregnancy, where the fertilized egg attaches in the fallopian tube instead of the uterus.
A tubal reversal restores your natural fertility level. That makes it an attractive option to many women.
Often patients are choosing between a tubal reversal and in-vitro fertilization (IVF). Dr. Goldberg notes there is an average pregnancy rate of about 50 percent for each round of IVF. However, IVF also requires two to four weeks of daily injections, frequent visits for monitoring, and nonsurgical removal, fertilization and placement of the eggs in the womb.
IVF also comes with a risk of multiple pregnancies (twins or triplets, for example), and it can be done only a limited number of times. On the other hand, after a successful tubal reversal, you and your partner can try to conceive every month on your own. The cost of the procedure is typically lower, especially if IVF doesn’t work on the first attempt.
“Before women have a tubal reversal, we always recommend that their partner have a semen analysis to have his fertility checked,” Dr. Goldberg notes.
If his results are poor, the chances of natural conception are low. IVF may be the better option in that case.
In the end, the decision comes down to your personal preference, needs and situation. A fertility expert can walk you through your options, because each comes with advantages and disadvantages.