Candidacy for tubal reversal depends on several factors such as age, health, and type of tubal ligation performed. Optimal candidates are typically under 40 who had their tubes tied right after childbirth. Tubal ligation done with rings or clips, or with only small parts of the fallopian tubes removed, are the least difficult to reverse.
Tubal ligation may not be appropriate if it is not likely to be successful. Age, BMI, type of tubal ligation, extent of damage to fallopian tubes, and other factors may make successful pregnancy less likely in an individual case. Some types of systems of tubal ligation, such as Essure, are not considered reversible.
Your doctor will likely have a prior consultation to ensure you are sure about your decision to have a tubal ligation reversal. You may require an exam called a hysterosalpingogram (HSG), which checks the length and function of your remaining fallopian tubes. This is performed using dye and X-rays, or saline solution and air along with an ultrasound. Both partners in a couple may need to be tested for other measures of fertility to determine if a tubal ligation reversal has a good chance of resulting in a successful pregnancy.
Blood thinners such as aspirin and other pain relievers should be discontinued 7 days before the procedure to reduce the risk of bleeding. If you can, quit smoking, as this will also reduce your risk of excessive bleeding. Your doctor will likely have you stop eating and drinking the night before surgery.
Recovery depends on the surgical method used for tubal ligation reversal. Laparoscopic methods may have no overnight stay, while open surgery may require a hospital stay of 1-3 days. Patients should expect to take pain relievers after the surgery. Laparoscopic treatment may cause nausea and pain in your shoulder, which is caused by bubbles of carbon dioxide gas becoming trapped against the diaphragm. That and other pain can typically be relieved by over-the-counter pain medication, or prescribed medication by your physician. Most women are able to go back to normal activity within 2 weeks of the procedure.
As with any surgery, there are risks of complications related to infection or adverse reactions to anesthesia. A proper assessment of every patient, along with complete lab work, will help to prevent postoperative complications. A postoperative course of antibiotics can reduce the risk of infection. Complications specific to tubal ligation reversal include damage to other adjacent organs. Pregnancy rates following tubal ligation reversal vary between 40 and 80 percent, and thus pregnancy cannot be guaranteed.