It is not uncommon for women who have had tubal ligations to change their minds about having more children. They may have regrets about their decision or have remarried or found a new partner and want children with these individuals.

They may find themselves at a crossroads between deciding if a tubal ligation reversal or in vitro fertilization is the best option for them.

If you are thinking about expanding your family and have had your ‘tubes tied,’ these are six points you should consider for achieving your goal.

The type of tubal ligation you had will affect your decision

A tubal ligation is a surgical procedure where the doctor cuts or blocks a woman’s fallopian tubes to prevent pregnancies. There are different techniques to achieve this, some of which are not conducive to reversal if they caused extensive damage to the fallopian tubes. If the surgery involved clips or rings, a tubal reversal might be possible. If the surgeon used Essure or Adiana systems that caused scarring to seal the fallopian tubes, it might not be reversible. Also, reversal may not be feasible if your tubes were burned or cauterized and there is not a sufficient amount of tube available.

Your fertility specialist will need to review the medical records from your surgery to advise you about this.

Tubal ligation is also called tubal reanastomosis

You probably will read descriptions of this surgery either using the term tubal ligation reversal or tubal reanastomosis. They are the same procedure. A reanastomosis means a reconnection of the fallopian tubes that were ‘ligated’ or closed using a ligature or clip.

This microsurgery is usually performed in an outpatient setting, and there are several different varieties of this procedure depending on the condition of the fallopian tubes. Each has the goal of rejoining the fallopian tubes though some are more complex than others, such as tubal reimplantation and neofimbrioplasty, a reconstruction of the finger-like projections at the end of the fallopian tubes.

Your age

The age of the woman seeking a reversal is another factor. If you are in your late 30’s or early 40’s, your natural fertility may have declined since the birth of your older children. Age may not be an issue if you are in your twenties. Your doctor should test your fertility with the appropriate tests.

One size does not fit all

This means each couple should determine their family size before they decide on which option makes sense for them. If you are only interested in having one child together, then it may make more sense financially, physically and emotionally to undergo in vitro fertilization than a surgical procedure. On the other hand, if you are hoping for two or more children, tubal reversal might be more appropriate.

A tubal ligation reversal is not a guarantee of success

According to the Mayo Clinic, there is a 40% to 80% chance of success after a tubal ligation reversal if all others variables, such as male and female fertility, do not impede pregnancy. Also, tubal ligation reversal is abdominal surgery and exposes patients to risks from infections, anesthesia, and injuries to nearby organs. In addition, women are at increased risk for ectopic pregnancy after this procedure.

On the other hand, IVF success rates will vary based on a woman’s age and other infertility diagnoses. But it can be an excellent alternative for patients with previous proven fertility.


No matter which option you choose, in most cases, your insurance will not cover either tubal ligation reversal or in vitro fertilization to reverse voluntary sterilization. Cost may be a key variable in your decision-making process.

If you are looking for a solution to reverse your tubal ligation, please contact us for an initial consultation. We are happy to help restore your fertility and expand your family.