Many women who have had tubal ligation surgery regret the decision and desire future fertility. Women who have had this surgery can often still conceive a pregnancy either through in vitro fertilization or after tubal reversal surgery. The decision about which of these options to choose needs to be based on each woman’s particular situation.
Factors that need to be considered when deciding between in vitro fertilization and tubal reversal surgery include the woman’s age, her egg count and quality, the particular type of tubal ligation surgery she underwent, and her partner’s sperm quality.
Female age is important to consider because as a woman gets older, both her egg reserve and egg quality decline. Chances of conceiving a pregnancy decline in our mid to late 30’s and by age 44-45 chances of conceiving a pregnancy are slim using either approach. For women considering tubal reversal surgery or in vitro fertilization, it is important to speak with a physician about assessing egg reserve and egg quality to see which of these fertility treatment options makes the most sense. For women in their mid-40’s, conceiving a pregnancy using an egg donor may be a more viable option.
Knowing what type of tubal surgery was performed is also very important. A tubal ligation surgery can be performed in a multiple ways. The tubes can burned, cut, completely removed, or a clip can be placed on them using a particular surgical device. Knowing the type of surgery can give your fertility specialist an idea of how much of the tubes may be remaining for a reversal surgery. The longer the length of the remaining tubal stumps, the higher the chance of success will be with tubal reversal surgery. Some women will have such little tubal length remaining that surgery isn’t even an option.
Sperm quality of the male partner is equally important to assess. If the male partner has an abnormal semen analysis, it may make more sense to do in vitro fertilization with intracytoplasmic sperm injection to give the sperm the best chance of fertilizing the eggs.
Lastly, the financial cost of each treatment option should be considered. Many fertility centers no longer even offer tubal reversal surgery because the cost associated with the surgery is often similar to the cost of an in vitro fertilization cycle. Since in vitro fertilization has higher success rates than natural fertility for many women, it is often makes the most sense to proceed with this treatment instead of tubal reversal surgery.
If you are considering fertility after a tubal ligation surgery, I would recommend speaking with a fertility specialist to have a full fertility evaluation and to discuss your treatment options.