Reversing Tied Tubes
Tubal disease occurs when conditions, such as endometriosis , cause damage to the tubes. Scarring from endometriosis can constrict and damage the tubes. Pelvic inflammatory disease is caused by severe infection and can create scarring of the tubes and other internal organs. Some women also want to have previous tubal sterilization reversed because of changes in their life situations.
A skilled reproductive endocrinologist may be able to successfully correct the tubal damage or reconnect the tubes. This depends upon many factors including the extent of damage, where it is located, how the tubes were “tied” and others. Pregnancy rates after successful tubal reversal surgery are approximately 75% over a two year period, with half of those pregnancies occurring within the first 6 months. Pregnancy rates after removal of scar tissue around diseased tubes depend on the amount of tubal damage, and range from 5-30% over two years.
When moderate to severe tubal disease is present, the best treatment option is usually in vitro fertilization Eggs are retrieved from the ovaries and they do not have to travel through the fallopian tubes. They are fertilized outside of the body and later embryos are transferred to the uterus.
In vitro fertilization will often result in 20-40% per cycle success rates, dependent on age and other factors. Although women may be more likely to become pregnant in one cycle of IVF, the cumulative pregnancy rates after tubal reversal may be higher. The advantage of tubal surgery is that there is no limit to the number of cycles that can be attempted whereas IVF is sometimes limited by cost.
The choice between IVF and tubal surgery depends upon numerous couple-specific variables, including female age and whether a male factor is also present. Most women in their thirties are candidates for IVF because the number of cycles they can attempt may be limited by diminishing egg quality. Younger women (those with good ovarian reserve) with tubes that can be repaired may be better candidates for surgery.