Ask An Expert: Reversing Tubal Banding

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Ask An Expert: Reversing Tubal Banding

Question:

Can a tubal banding be reversed?

Answer:

Tubal banding, also called tubal ligation, can be reversed, but success rates are modest. Tubal ligation is a popular and effective method of contraception. The procedure results in blockage of a woman's fallopian tubes. This prevents sperm deposited in the vagina from reaching the egg. It is intended as a means of permanent sterilization in women who have completed their family.

Several techniques are available for performing tubal ligation. The most common approach is through a laparoscope, a small telescope passed into the pelvic cavity through the abdomen. The fallopian tubes are identified. Through the scope, the doctor can place a rubber band around them to create the blockage.

There are other laparoscopic methods to create fallopian tube blockage. The doctor can use a plastic clip placed across the tubes or electrocauterization to seal the tubes closed.

If a woman has her tubes tied right after delivery, it is performed through a small incision in the abdomen. In this technique a segment of the tube is cut out and the ends tied. A newer technique uses a hysteroscope, which is passed through the cervix. The tubes are then blocked from the inside by placing a plug.

Women are counseled to choose tubal ligation for birth control only when they have finished childbearing. However, 10 to 20% of women will later regret their decision. A very small percent will actually want to reverse the procedure.

Surgery can be done to reconstruct the tubes by removing the damaged segment and rejoining the ends. However, the procedure carries risk and is expensive. Pregnancy success rates vary substantially depending on the patient's age and type of tubal ligation originally performed. Overall, about 60% of women successfully achieve pregnancy.

In vitro fertilization is sometimes recommended as an alternative to tubal ligation reversal.

Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.

Last updated:	March 14, 2007
Reviewed By:	Faculty of Harvard Medical School