Is Tubal Ligation Reversal the Best Consideration?

A recent trend that has been seen is with regards to individuals who have previously had a tubal ligation now interested in having another child.  For these individuals, the first thought is too complete a tubal ligation reversal.  But, is this the best, most-optimum consideration?

First, considerations with regards to the outcome post tubal ligation reversal must be made. One involves the understanding that even a successful tubal ligation reversal will still lead to time to conception being significantly extended. Additionally, the unfortunate fact exists that many of tubal ligation reversals are not successful and the tubes remain blocked post reversal or only one tube becomes open.  Obviously, this is suboptimal and less than a desirable outcome.  Many factors can lead to a suboptimal outcome or failure outright of a tubal ligation reversal.  Lastly, the cost of a tubal ligation can often be near $10,000 and in most situations’ insurance coverage is not available.

If, after making these considerations one is still interested in considering tubal ligation reversal then the age and ovarian reserve of the individual needs to be evaluated plus the male fertility factor. If one is relatively young, generally under the age of 32, has good ovarian reserve, minor to no male factor is present and the individual/couple is willing to give it some time, then tubal ligation reversal may be an option to consider.

However, if one does not have excellent ovarian reserve, is over the age of 32, and/or the presence of a male factor exists, then tubal ligation reversal should not be considered, as failure rate is extremely high and the need for successive IVF is almost assured. 

In general, these are the few factors that relate to when one may consider tubal ligation reversal.  Additional factors one may wish to consider would include:

  • The time that has passed since the initial tubal ligation
  • Type of tubal ligation that was performed, (i.e. segmental resection, Filshie clips, “burning,” etc)

These all contribute significantly to the potential success rate and outcome of a tubal ligation reversal.

In most situations, In Vitro Fertilization (IVF), would be the recommended course of treatment as it provides the highest rates for success in a typically shorter window of time.

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