Reversal of Tubal Sterilization
Tubal reversal surgery is a successful treatment for many couples at our Seattle Washington infertility clinic. The success of the operation depends upon several factors including:
- The female’s age
- The amount of fallopian tube that was damaged at the time of sterilization
- Whether electrocautery was used as the electrical burn often spreads to, and damages, adjacent tissues.
- The length and health of the remaining fallopian tube
Tubal reversal surgery is a straightforward surgical procedure where the segment of the damaged fallopian tube is removed and healthy tissue is rejoined to produce a functional fallopian tube.
Prior to surgery, it is important to
ascertain the patient’s candidacy for the procedure.
It is also necessary to determine if there is a good
chance that tubal reversal surgery will result in a pregnancy
by ruling out other potential causes of infertility.
The following tests should be performed prior to considering
tubal reversal surgery:
analysis to insure that the male partner is
- A thorough evaluation of the previous operative report detailing the sterilization procedure and the amount of damage to the tubes. Review of pathology reports is also helpful
- In patients over 35 seeking tubal reversal surgery, a day
3 FSH and estradiol blood test should be performed
to exclude premature menopause and decreased fertility
- Documentation of ovulation by day 21 progesterone blood tests
- A hysterosalpingogram
(HSG) is helpful in documenting how much tube
is still attached to the uterus. This is important
as anastomosis made “tube-to-tube” has
a significantly higher success rate than when the
tube is connected to the uterus.
Once a patient is deemed suitable for tubal reversal surgery, the procedure is performed using the latest microsurgical techniques. The hospital stay and time off work are minimal. Our success rates with tubal reversal surgery are excellent.
Dr. Kustin, infertility specialist, will evaluate each case
separately and he will advise whether it is feasible
to proceed with tubal reversal surgery.
Some cases are not suitable for this procedure and
the chance of success may be much better using IVF and embryo transfer. This is because the integrity
of the fallopian tubes is not important to the success
of an IVF cycle. In IVF, the eggs are aspirated directly
from the ovary, mixed with the partner’s sperm
in the laboratory, incubated, and the resultant embryos
are placed directly into the uterus.
Many couples, as well as those
who have experienced failed tubular reversal surgery,
may opt for in
vitro fertilization. In general, the per cycle success rates with
IVF exceed those of tubal reanastamosis. The advantage
to tubal reversal, especially in younger women, is
that there is no limit (other than age or other conditions
causing infertility) to the number of times conception
can be attempted in a natural cycle. The number of
IVF attempts may be limited