Learn more about tubal reversal from our fertility experts.
Many women choose to have a tubal ligation as a permanent form of birth control. Unfortunately, life circumstances change and some women or couples later regret their decision to have a tubal ligation. There are options to having children after a tubal ligation, one of which is tubal ligation reversal surgery. At Texas Fertility Center, Dr. Anthony Propst is our primary surgeon for patients requesting a tubal reversal. Reversing your tubal ligation is a delicate procedure that requires experience and skill. Dr. Propst is a board-certified reproductive endocrinology and infertility specialist with special training in microsurgery and robotic laparoscopy. He has more than 20 years’ experience performing tubal reversal surgery.
Who is a good candidate for a tubal reversal
You are probably a good candidate for surgery if your tubal ligation was done by separating (ligating) the tubes either shortly after delivery or by laparoscopic surgery at a later time. If the Fallopian tube was removed instead of ligated then a reversal is not possible. Women who are ovulating regularly and whose husband or partner has a normal sperm count are also more likely to conceive after the surgery. We will review your tubal ligation operation report (if available) prior to your surgery. We will also have your husband or partner do a semen analysis.
There are two surgical methods to perform the tubal reversal.
A mini-laparotomy is a small incision (about 3 inches) that is done at the pelvic hair line, similar to the location of a Cesarean section. The fallopian tubes are identified and the ligated ends of the tubes removed. The now open tubes are then connected together using very fine sutures and checked to see that the fallopian tubes are now open all the way to the end of the tubes. The surgical incision is then closed. Many patients can go home the same day if they chose. You can also stay overnight at the Bailey Square Surgical Center (close to Seton Main Hospital) for no additional fees.
Robotic-assisted laparoscopy is another method of tubal reversal. The da Vinci surgical system t uses a computerized robot to assist the surgeon in removing the ligated ends of the fallopian tubes and sewing the open ends together. This complicated surgery is completed through four small incisions each less than one-half an inch. These small incisions enable you to recover from surgery sooner. Patients are able to go home from surgery the same day. For obese patients, robotic-assisted laparoscopy is the preferred method for tubal reversal. The robotic-assisted laparoscopic surgeries are performed at St David’s Round Rock Medical Center.
Both methods of tubal reversal surgery have similar success rates. The length of surgery and the cost of surgery are higher for the robotic-assisted laparoscopy. The quicker recovery time and less postoperative pain are advantages of the robotic-assisted laparoscopy.
Before we can schedule your surgery we will need to see you for a new patient visit.
This visit can be done in our Austin or Round Rock offices. The new patient office visit lasts approximately one hour. If you have a copy of your tubal ligation surgical report, please bring it to your visit. You can also coordinate having your surgical report and other records sent from your Ob/Gyn or Primary Care physician to our office ahead of time by completing a medical records request.
The pregnancy rates following mini-laparotomy or laparoscopic tubal reversal range from 60-80% in reported studies.
Women who are younger and have longer fallopian tubes (less tube destroyed during the tubal ligation surgery) have higher pregnancy rates. Although uncommon, the risk of an ectopic pregnancy (pregnancy in the fallopian tube) is higher after tubal reversal surgery.
Compared to the option of in vitro fertilization (IVF), tubal reversal is less expensive and gives you the opportunity to conceive naturally. Please contact our office to schedule an appointment to discuss tubal reversal options in both our San Antonio and Austin fertility centers.