We commonly get calls from women who would like to have another baby after tubal sterilization (having their tubes “tied”). While tubal ligation is intended to be permanent sterilization, there are options for attempting pregnancy after this surgery.
It is important to first understand what is actually done with tubal ligation. There are actually a number of variations for tubal ligation. Probably the most common method involves removing the mid-segment of each tube and sometimes cauterizing (burning) the cut ends. Another common method involves placing small clamps on each tube. Tubal ligation prevents pregnancy by blocking the egg from the sperm.
There are two options for attempting pregnancy after tubal sterilization.
Tubal reversal or microtubal anastomosis involves removing a small amount of the damaged fallopian tubes (where the tubes were cut or clamped) and sewing the portions together under a microscope. The surgeon, in essence, puts the tubes back together. This procedure is a very delicate surgery and requires a qualified, experienced surgeon. This surgery usually involves a small incision (about 3 inches) just above the pubic bone—this is sometimes referred to as a bikini cut. Patients are in the hospital for a couple of days, and back to work in about three weeks. The likelihood of success is dependent upon the about of undamaged fallopian tube remaining. Pregnancy can be attempted beginning as early as four weeks after surgery. An advantage to tubal anastomosis is that you can continue to attempt pregnancy for many cycles.
In vitro fertilization
In vitro fertilization (IVF) involves stimulating the ovaries to grow and mature several eggs, retrieval of the eggs from the ovary(ies), growing the embryos, and transferred the best embryo or two into the uterine cavity. This procedure does not involve surgery or hospitalization but does require frequent office visits and an office procedure to retrieve the eggs from the ovaries. An advantage to this procedure is that neither surgery or hospitalization are required, but if pregnancy does not occur, the process must be repeated for another attempt.
What should you do if you elect to pursue pregnancy after tubal ligation?
The first thing you should do is make an appointment to see Dr. Cecil Long or Dr. Karen Hammond at America Institute of Reproductive Medicine in Homewood, Alabama (a Birmingham suberb). We will ask you to obtain a copy of your operative report from the physician who performed her tubal ligation to bring with you to your initial appointment. It is helpful if your husband or male partner accompanies you for that visit—he will need a semen analysis (sperm count) before your treatment. At that visit, we will review the options with you in detail and help you decide the best treatment for you. We will help you with other screening and testing that may be needed prior to the treatment you decide.
Keep in mind, insurance may or may not cover tubal reversal or IVF. You should contact your insurance company to check on your policy’s coverage. This knowledge may help guide your treatment, as well.
We would love the opportunity to speak with you about your family building options. Please give us a call at 205-307-0484.
Karen R. Hammond, DNP, CRNP
Dr. Hammond is an internationally known Women’s Health Nurse Practitioner with more than 30 years of experience in Reproductive Endocrinology and Infertility. She and Dr. Cecil Long are both accepting new patients at America Institute of Reproductive Medicine in Birmingham, Alabama.