South Jersey Fertility Center

“Permanent” sterilization by tubal ligation is the most common form of contraception in women age 30 and older. In women, the tubal ligation involves obstructing the mid-portion of the fallopian tube (the duct through which the egg must travel to reach the uterus). Once the tube is obstructed, the sperm cannot reach the egg to fertilize it. Various methods have been used to ligate (tie) tubes, such as elastic bands, small metal clips, suturing, and burning with electrical cautery.

Fortunately this form of contraception can often be reversed by a procedure called Tubal Reversal. Another option  is In-Vitro Fertilization (IVF). Each of these two options has its advantages and disadvantages. It is up to the individual or couple to decide which option best fits their lifestyle once they understand the medical pros and cons.

Sterilization reversal surgery for women is highly successful if a sufficient length of tube remains on both sides of the ligation. Often the operative report from the tubal ligation procedure is useful in identifying candidates who do not have a good chance for successful reversal. In approximately 5% of cases, the tubal reversal surgery cannot be performed due to unexpected findings in the pelvis at the time of the intended reversal surgery. These findings include scarring of the fimbriated end of the tubes or absence of the fimbria. The fimbria are the tiny finger-like structures that sweep the egg into the tube from the ovary.  If the fimbria are damaged or absent, reconnecting the tubes will still not result in a pregnancy.

We perform the tubal reversal surgery by the laparoscopic approach (through small key-hole incisions) with general anesthesia (the patient is completely asleep) at the Surgical Center of South Jersey, Mt. Laurel, NJ.  The two ends of the tubes are reconnected using very fine suture material to reduce the chance of scar formation.  The patient goes home the same day as the surgery, and can return to work  one week later.

The tubal reversal surgery requires a high level of expertise; therefore, you should choose a reproductive surgeon who has completed a fellowship in Infertility and  is board certified in Reproductive Endocrinology and Infertility.  Our tubal reversals are performed by Dr. Peter Van Deerlin, who is Board Certified in Reproductive Endocrinology and Infertility, and has been doing tubal reversal regularly since 1997.  Dr. Van Deerlin has also completed a course on Advanced Laparoscopic Surgical Skills for Tubal Anastomosis at the MOET Institute (Microsurgery and Operative Endoscopy Training).

If we perform your surgery, the chance that you will have a normal pregnancy within one year of the surgery is 70%, assuming that you are under the age of 40. Women between the ages of 40 and 44, who demonstrate on a blood test that they have adequate ovarian reserve, have a pregnancy rate that is half of that. An advantage of the surgical approach is that if you successfully conceive a pregnancy, you can usually go on to have more pregnancies if your desire. Of course this could also be a disadvantage if you want to have only one more child and don’t want to have to worry about subsequent contraception. Another disadvantage is that there is a 5% incidence of tubal pregnancy following a surgical reversal. If your medical insurance doesn’t cover the tubal reversal procedure, the total cost to you is approximately $6850, which includes the procedure, anesthesia and surgical center fees.

For a comparison of tubal reversal versus IVF, see the table below.