Significance

• Some women choose this procedure because they have experienced post-tubal ligation syndrome. The symptoms of this syndrome may include loss of sex drive, menstrual problems such as painful, heavy or irregular periods, and symptoms of early menopause like hot or cold flashes. A majority of women opt for tubal ligation reversal though, because they have a desire to have another child. This desire can be contributed to feeling as though they chose sterilization too soon, marrying again and wanting to have a child with their new spouse, or because they have lost one of their children to an early death. The average cost for a tubal ligation reversal is between $6,000 and $10,000, depending on the doctor.
  
  

Function

• Before a surgeon will perform a tubal ligation reversal, he will evaluate you to determine what your chances of conception may be. He will need to know what the sperm count of your partner is, perform an X-ray to determine how much of the fallopian tube is left, and he will require the operative and pathology reports from the surgeon who performed your tubal ligation. If he feels that your chances of conceiving are fairly high, he will proceed with the surgery. The reversal is completed by "untying" the ends of the tubes and reconnecting them. The fallopian tubes are generally 8 inches in length before the initial tubal ligation was performed, so for a reversal to be successful, the tubes need to be 3 to 4 inches in length once they are reconnected. You can attempt conception after the menstrual cycle that follows the procedure, and pregnancy should occur within 6 to 12 months.
  
  

Types

• There are a couple of ways a tubal ligation reversal is performed. The method used will depend on the method used for the initial tubal ligation, as the amount of damage done to the tubes is a factor in the success of the procedure. The first way to perform a tubal reversal is called a laparotomy. This involves making a cut in the abdomen to free the blocked tubes, and then rejoining what is left of the tube that was not damaged after the tubal ligation itself. Another method used is the mini laparotomy. Ideally, the woman needs to be within a 20-percent range of her ideal body weight. The abdominal cut will be much smaller than that made during a laparotomy, only 6 cm, and it will require a hospital stay of less than two days. Time for recovery could range from a few days up to four weeks.
  
  

Considerations

• Before choosing to have a tubal ligation reversal, you must first think of the cost in comparison to your chances of conception. For women under the age of 30, the pregnancy success rate is 77 percent. For women who are between the ages of 35 and 39, the success rate drops to around 62 percent. And for women over the age of 40, the rate drops even lower, to a staggering 34 percent. Also, if your tubal ligation involved cauterization (burning of the ends of the tubes once tied and cut), your chances for a successful reversal are much lower due to the damage caused to the tubes. In cases when the chances for a successful tubal ligation are low, in-vitro fertilization may be considered. Though a more costly way to conceive, it is a good choice for those whose tubes are not in good enough condition for the reversal procedure.
  
  

Warning

• Picture of an ectopic pregnancy, courtesy of google.com.
  
  Just as with any other invasive medical procedure, there are risks involved. One of these risks is excess bleeding if the blood vessels become damaged during the tubal reversal. There is also a risk for an adverse reaction to the anesthesia used, as well as the risk for infection once the procedure is complete. In addition, there is a chance of having an ectopic pregnancy. This occurs because of the damage in the fallopian tubes, which causes the fertilized egg to remain in the tube, rather than move into the uterus. In this instance, the embryo will begin to develop in the tube, causing an expansion of the organ. If it is not detected in time, the fallopian tube could burst, resulting in the death of the mother. The chance of developing an ectopic pregnancy after a tubal ligation reversal is between 6 and 10 percent.