Refers to surgical procedure restoring fertility to women after a tubal ligation sterilization procedure.
Reconstruction of the fallopian tube to restore its anatomy and function after tubal sterilization.
Three types of tubal reversal procedures: tubal anastomosis, tubal implantation and ampullary salpingostomy.
Tubal anastomosis involves drawing together the two tubal openings with a retention suture and microsurgery to join the musculature and outer layer of the tubal segments.
When a tubal ligation procedure leaves only one segment separated form the uterus and no segment attached to the uterus a new opening can be made via the uterine muscle and the remaining tubal segment can be inserted directly into the uterus, known as tubal implantation.
In patients who have had a fimbriectomy type of tubal ligation, the tube segment that remains still connected to the uterus can be opened by an ampullary salpingostomy and the internal lining folded out over the end of the tube.
Pregnancy rates after such procedures related to a woman’s age, the specific tubal ligation procedure, with approximately 70% achieving pregnancy.
Younger women undergoing this procedure have the highest success rates for pregnancy.
Tubal Reversal Pregnancy Study indicated an overall pregnancy rate of 69%, ranging from a high of 82% for women and under 30 years of age and a low of 41% for women age 40 and over.
The procedure with the best sterilization method for reversal is tubal blocking with rings or clips.
A women’s age is a better predictor of tubal reversal success that the specific method of tubal sterilization.
Following the procedure about half of the pregnancies result in birth, one third in miscarriages and 15% in ectopic pregnancies.
The miscarriage rate is not different that in the general population, but the e topic pregnancy rate is significantly higher than the 2% rate in the general population.
Ectopic pregnancy is the main risk factor associated with the procedure.