Tubal ligation or bilateral tubal obstruction (female sterilization) is a form of contraception that involves surgically cutting or blocking a woman’s fallopian tubes which avoids the eggs and sperm encounter as well as the following transport of the resulting embryos into the uterus.
Tubal ligation is considered a very effective and permanent method of sterilization, practiced to more than 650 thousand women each year in the United States only.
Treatments to achieve pregnancy after a tubal ligation
Tubal ligation is considered a permanent method of sterilization; however, if you have undergone this procedure but want to conceive, there are two possible options:
- In-Vitro Fertilization (IVF)
- Tubal ligation reversal surgery or tubal recanalization
In an In-Vitro Fertilization (IVF) procedure fertilization occurs under controlled IVF laboratory conditions to create embryos with higher implantation potential which are later transferred directly into the patient's uterus. This means the fallopian tubes are no longer needed for the egg and sperm to meet and to carry the embryo into the uterus.
Because of the great advantages of IVF against the tubal ligation reversal surgery at Ingenes we do not recommend this surgical procedure as a first choice and we only perform it when the patient chooses it, despite of knowing the risks and disadvantages.
Advantages of In-Vitro Fertilization
- Possible complications of surgery are reduced
- It eliminates ectopic pregnancy risks
- It is possible to achieve pregnancy in just a few weeks, whereas with tubal ligation reversal surgery, the patients need to wait up to a year to see results (if any)
- Some types of ligation are not surgically reversible
- Success is more likely in IVF if there are other infertility causing conditions in the couple
- When combined with other methods such as Preimplantation Genetic Testing for Aneuploidy (PGT-A), it is possible to detect common genetic and chromosomal abnormalities in women, which is especially important in women over 35
- After achieving pregnancy the woman remains sterilized and thus it is not necessary for her to go through another tubal ligation surgery or that the couple needs to use contraception again
Advantages of tubal ligation reversal surgery
- If successful, no further intervention is required to achieve pregnancy as long as the couple is still fertile.
- If the patient is still fertile, artificial ovarian stimulation with specialized medicaments is not necessary to stimulate egg production.
Tubal ligation reversal surgery or tubal recanalization
Tubal ligation reversal surgery or tubal recanalization is a microsurgical procedure in which in which the two separated fallopian tube segments are joined using microscopic stitches.
In some cases this allows the egg to travel from the ovary to the uterus and be fertilized by sperm at the same time. However, this does not guarantee fertility restoration because the patient’s fallopian tubes may have lost their functionality.
Although usually ambulatory, total recovery from tubal recanalization surgery can take up to several weeks. It is important to consider that tubal recanalization is a much more complicated procedure than IVF and its associated risks may include:
- Possible adjacent organ damage
- Pelvic adhesions formation
- Risks associated to anesthesia
- Recanalization impossibility
Not all types of tubal ligation are surgically reversible. Depending on the condition of your fallopian tubes, you may not be a plausible candidate for tubal ligation reversal surgery or may have very little chance of achieving pregnancy after this.
In addition, there is an increased risk of subsequent ectopic pregnancy caused by tubal recanalization due to the possible pelvic adhesions formation and fallopian tube narrowing, which can block the passage of the fertilized egg into the uterus.
If successful, the biggest advantage of tubal ligation reversal over In-Vitro Fertilization is that no further intervention is required to achieve pregnancy as long as the couple is still fertile.
If it is ineffective, however, it is likely that you end up undergoing an In-Vitro Fertilization cycle anyway. In addition, after achieving pregnancy you and your partner must begin using some kind of contraception or go through another surgical sterilization procedure if you do not want to have more children.
Meanwhile, the biggest advantage of In-Vitro Fertilization is the risks of undergoing a surgical procedure can be reduced. It is also possible to achieve pregnancy after a few weeks long treatment, whereas with tubal ligation reversal surgery you would need to wait up to a year to see results (if any).
If you opt for In-Vitro Fertilization it is very important that you choose a first level assisted reproduction institute to really benefit from this procedure and avoid any possible complications. As you need to take specific medication to stimulate egg production (which can imply risks such as ovarian hyperstimulation syndrome) it should be carefully monitored by experienced specialists.
At Ingenes we have Mexico’s largest market share regarding high complexity technologies and pregnancy rates above the US fertility clinics average. We also have highly qualified specialists in both In-Vitro Fertilization and tubal ligation reversal procedures, so we can help you decide on the most fitting option based on your overall medical history.