Surgical Reversal of Tubal Ligation Versus IVF
As one of the results of divorce and subsequent remarriage, a common question posed to fertility treatment centers is whether microsurgical tubal reversal (MTR) or IVF is a better option to attain pregnancy when no other factors contribute to infertility. Both options are clinically reasonable and each woman should become educated about the advantages and disadvantages of each before making a decision.

About Tubal Ligation Reversal Surgery
Tubal ligation reversal is a procedure that rejoins the segments of the fallopian tubes so that eggs can become fertilized. It was once primarily performed in an inpatient situation, requiring 3 hours of surgery, several day hospital stay and month long recovery though things have vastly improved. Fertility treatment centers now perform tubal reversals as an outpatient procedure, frequently using laparoscopy technology; greatly reducing pain, recovery time and procedure expense.

Pregnancy Success Rates After Tubal Ligation Reversal
It is difficult to get specific estimates on the success rates for pregnancy after tubal ligation reversal because not as many studies have been done and, like in IVF, success varies between fertility treatment centers. While studies do suggest that IVF has a higher immediate success rate, it is limited to the amount of procedures a patient can afford, should it not be successful or more children are wanted. The opportunity to conceive after a reversal of tubal ligation is limited only by the couple’s individual contributing fertility factors.

Contributing Factors
As in any course of fertility treatment, it is difficult to know the exact possibility of success or failure. Whether it is success or failure, for the patient experiencing it; it is 100%. It is however possible to know the facts and weigh the possibilities in the balance.

• Before making a decision, it is advisable to know the male partner’s sperm quality. If it is poor and either low in count or motility, it may necessitate and IVF procedure.
• Age of the patient in any fertility treatment is always a consideration. The chances of pregnancy significantly decrease at age 43.
• The status of the tubes also plays an important part. The length of the remaining stumps can determine increase the patients chances if they are longer or decrease the chances if they are shorter. The condition of the fimbria at the end of the tube which essentially pick up the egg upon release, also determines the chances of success.
• Current pelvic conditions. The amount, extent and location of scar tissue can impact the successful outcome after a reversal.

Advantages of Tubal Reversal
There are two main advantages to a surgical reversal of a tubal ligation. One is that because no fertility medication is used, the multiple pregnancy rate is only 2% compared with 25% for IVF treatment. The second major advantage is that there is no need to have another procedure to try to achieve another pregnancy.

When weighing the options, it is important to discuss the options with the reproductive endocrinologist and know the preference of the fertility treatment center, as well as their expertise in tubal reversals.