Reversing Vasectomies and Tubal Ligations
Exploring Reversal Surgery, Success Rates, and Costs
Oct 14, 2008
Many couples seeking to undergo a vasectomy or tubal ligation reversal are often surprised at the complexity of the surgery, the success rate of achieving pregnancy, and the costs of surgery.
Why Do Couples Choose to Reverse Vasectomies and Tubal Ligations?
The most common reasons a couple would change their minds about having another child are due to one or more of the following:
- Desire to add to the current family
- Desire to conceive after a remarriage
- Desire to conceive after the loss of a child
- A change in financial status
- Discomfort due to post-tubal ligation syndrome (heavy periods, early menopause, loss of libido, and mood swings are among the symptoms of PTLS)
It is estimated that up to 10% of men who underwent vasectomies and up to 25% of women who underwent tubal ligations end up seeking a reversal.
Vasectomy Reversal Surgery and Recovery
During a vasectomy, the tube that carries sperm outside of the penis (the vas deferens) is cut. A reversal attempts to reattach the severed vas deferens. In most cases of vasectomy reversal, the surgeon will use a high-powered microscope to reconnect the severed ends of the vas deferens. In more rare cases, the vas deferens will need to be attached to the epididymis when there is a blockage preventing sperm from exiting the penis. During surgery, the patient will be under general anesthesia. As with any surgery, there is a risk of excessive bleeding and infection.
Recovery from the reversal will be similar to that of the original vasectomy. Men will take prescription pain medication and will need to wear a supportive cup for six weeks. They will be unable to bathe or swim for two days following surgery. Patients will also need to avoid sexual intercourse or ejaculation for four weeks. Heavy exercise should also be restricted.
Vasectomy Reversal Success Rates
According to Vasectomy Medical, it takes approximately one to two years for a pregnancy to occur after a vasectomy. Vasectomy usually leads to pregnancy in about two out of three cases. If many years have passed since the initial surgery, or if the vasectomy was close-ended and both tubes of the vas deferens were severed, success will be more unlikely.
A vasectomy reversal has failed when no sperm are being ejaculated. At this point, the reversal can be repeated or sperm can be extracted from the testicles and either united with the egg outside of the womb or injected into the cervix to fertilize an egg on its own.
Tubal Ligation Reversal Surgery and Recovery
A tubal ligation normally involves the burning, tying, or cutting of the fallopian tubes, sometimes making a reversal difficult. Some tubal ligations, however, are performed by placing a ring or a clamp on the tube to prevent egg release. During the reversal, the surgeon will use a high-powered microscope to make a four to five centimeter incision at the bikini line and either rejoin the two sections of fallopian tube or remove the clamp or ring. In some cases, the surgery can be performed laparoscopically. During the reversal, the patient will be under general anesthesia, and will be hospitalized for a few days after surgery due to its invasive nature. As with any surgery, there is a risk of excessive bleeding and infection
After surgery, the patient will only be able to consume clear, non-carbonated liquids until bowel activity has returned to normal. Due to muscle soreness and burning around the incision site, women should take pain medication and restrain from heavy lifting. Women should be encouraged to walk short distances to stimulate healing. In general, it takes up to two weeks to recover from the surgery.
Tubal Ligation Reversal Success Rates
Success depends upon the type of tubal ligation originally performed, the age of the woman at the time of the reversal, and the amount of damage to the tubes during the original tubal ligation. Women seeking reversals will have a higher success rate if a ring or a clip was placed on their fallopian tube, or if only a small section of the tube was removed. Success rates can vary from 20-70%. However, many women achieve a pregnancy within a year of the reversal surgery. Women unsuccessful with a tubal ligation reversal should consider in-vitro fertilization.
Costs of Both Surgeries
Vasectomy and tubal ligation reversals both cost on average $10,000 in the United States.
Neither a vasectomy reversal nor a tubal ligation reversal is a guarantee that a pregnancy will be achieved. However, both surgeries are often less costly than other infertility treatments. A vasectomy reversal or a tubal ligation reversal should be considered by any couple seeking to expand their family.
 |
