Will I get pregnant if I have tubal ligation reversal surgery (have my tubes “untied”)?

Studies show that with proper microsurgical tubal reversal technique the tubes are open again upwards of 90% of the time. Even though we fix your tubes you may not get pregnant. What matters to you, and us, are your chances of a baby. The probability of pregnancy is higher with some, and with some it is lower.

This is probably the most common question we get. Your exact chances depend on so many things that the answer for you depends on your particular situation. Probably the most important question is how easy was it for you to get pregnant before you had a tubal ligation. If you have good underlying fertility, that goes a long way. A tubal ligation reversal is unlikely to make you more fertile than you would be if you never had your tubes tied. Your underlying fertility is in the 75% range in your 20’s, approximately 62% from 31 to 35 and 54% over age 35. If we reverse your tubes your tubes won’t usually keep you from being pregnant. Some factors are associated with excellent fertility. If you ever got pregnant on the pill or shortly after stopping it you have good underlying fertility. If you or a female blood relative has had twins or been pregnant after age 40 that is good news for you.

Sometimes we find adhesions or other things that we fix to improve your chances of getting pregnant but that is not too often. One advantage of doing no more than three cases a day is that we can take the time to do these things when necessary. It’s important to have as much length in the repaired tube as possible. Some tubal ligation methods do not leave a lot of tube to fix.

Age is important; your fertility declines gradually after age 35, after age 40 it drops off significantly. The average age of our patients is about 37 years and a lot of them are getting pregnant so don’t let your age be the only thing stopping you. We test your tubes with dye before we finish your operation this makes sure that they are open and we feel that improves your chances of a successful pregnancy.

When we sew your tubes together we sew from the inside out closing the inner muscular layer of the tube separately from the outer serosal layer. Many doctors who do reversals just sew around the outside, they say they don’t need to do it in layers or dye test the fallopian tube to ensure that they are open. Don’t confuse closing the abdomen in layers [everyone does that] with closing the tube in layers.

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