No. There is no convincing evidence to support the development of abnormal menstrual patterns following sterilization. Pre-procedure pregnancy or the use of the combined OCP may have masked irregular menstrual cycles.

Can a tubal ligation be reversed?

Yes. Reversal of tubal ligation requires specialized surgery that may be very expensive. Some women are not suitable candidates because of the way the sterilization was performed (if too much tube was damaged or if the fimbriated ends of the tubes were removed). Sterilization reversal carries the usual operative and anaesthetic risks of major abdominal surgery as well as the risk of failure and ectopic pregnancy.

Tubal ligation (also called female sterilization) seals the fallopian tubes so that the egg and sperm cannot meet. The procedure may be done either laparoscopically (in which viewing and operating instruments are inserted into the abdomen through small incisions), or by minilaparotomy (where the surgeon uses a small incision to open the abdomen and seal the tubes).

The tubes may be sealed using cautery (burning the tubes), with specially designed clips or rings, or by cutting a portion of the tubes.

This procedure has no effect on the ovaries, which produce the hormones that control menstruation and menopause. Thus, it has no effect on when menopause occurs.

For many years it was believed that tubal ligation may cause menstrual irregularities including increased bleeding, bleeding between periods, and menstrual pain ("post-tubal ligation syndrome"). However evidence does not support the existence of "post-tubal ligation syndrome".

A large study published in 2000 reported that there was no difference in hormone levels and little difference in menstrual cycle characteristics after a tubal ligation. Women who have had a tubal ligation are no more likely to have menstrual irregularities than those who didn't have the procedure.

Tubal ligation reversal is the process of rejoining the separated tubes which have been severed during tubal ligation to allow the woman to become pregnant again. Tubal ligation reversal is a very delicate surgery and should only be done by a surgeon who is an expert on the procedure.

Some doctors recommend that you discuss the following with your husband and doctor first before deciding for a tubal ligation reversal.

First, look at the quality of your husband‚Äôs sperm. If the sperm quality is poor, your doctor may recommend IVF instead.

Secondly, have your doctor assess the length of your fallopian tubes. Longer fallopian tubes give you an increased chance of successfully having a baby after reverse tubal ligation compared to shorter tubes.

Your age is also a factor which may increase your chances at conception. Women who are nearing menopause often have lower egg reserves than younger women. In cases like this, IVF may be considered a better option than tubal ligation reversal. The egg quality, not only the count, may also be lowered in women of advanced maternal age and should also be taken into account.

The current condition of your internal reproductive system should be assessed. Scarring, polycystic ovarian syndrome, endometriosis, etc. can severely affect egg production and transport to the uterus. If the entry of the egg into the uterus is blocked by scar tissue as a result of a previous inflammatory condition, fertilization cannot occur.

Women who have undergone tubal more ligation and lived to regret it, especially if they want to bear more children, have two options for conception: tubal ligation reversal or in vitro fertilization. However, both have their pros and cons and a woman may be suitable for one, while another woman may be more suitable for the other.

Tubal Ligation Reversal

A tubal ligation reversal is done to reconnect the cut portions of the fallopian tubes to allow the woman’s eggs to pass through. However, if the main purpose for tubal ligation reversal is to resume conception, a few factors are also involved. These are the husband’s sperm quality, the length of the tubal stumps that need to be reattached, the status of the other components of the reproductive organs, and the quality and quantity of the woman’s eggs.

In some cases, low sperm count or poor sperm quality will lower the chances of conception with tubal reversal, and IVF may be a better option in this case. The length of the remaining tubal stumps is also important. The longer the tubal stumps to be reconnected are, the better the chances for success. Also, the woman needs to be free of other reproductive problems which can lower the chances for conception like pelvic endometriosis and scar tissue, which is not a factor for success in IVF. Finally, the quality and quantity of the woman’s egg should also be considered. Despite a successful tubal ligation reversal procedure, low egg quality could necessitate the need for IVF and the use of an egg donor.

Approximately 70% of women who have had tubal ligation reversal will become pregnant, although success can depend on the woman’s age and the method of tubal ligation done. The main risk in tubal ligation reversal is the increased chance of an ectopic pregnancy if conception was made possible. Because tubal ligation reversal is a form of surgery, common risks involved in surgery, like infection, pain, allergic reactions to surgical drugs and anesthesia, as well as tissue trauma, are also possible.

In Vitro fertilization

In this procedure the woman’s reproductive system is stimulated to produce eggs using medications and these eggs are harvested and fertilized with the husband’s sperm. After successful fertilization the resulting embryo is transferred to the woman’s uterus where it can complete its development. The biggest advantage of IVF over tubal ligation is that there is no surgery involved and the outcome can be known just a few days after the procedure was done, compared to the year-long wait needed after tubal ligation. A multiple pregnancy is the biggest risk in IVF, although this risk can be minimized if the number of eggs is restricted to one or two. In vitro fertilization is fairly expensive, and if the first attempt fails, a second attempt can be made if the couple chose to have a back-up set of eggs frozen after the harvest.

The decision to have either one of these procedures in order to have a baby depends on the woman and the clinical picture of her and her partner’s reproductive health. In some cases, problems in the reproductive system in either or both partners may render tubal ligation reversal useless and may necessitate the need for IVF.

Understanding Tubal Ligation Reversal Recommended Resources:

UAB Health System

Franciscan Skemp