Motherhood Reborn

Tubal Ligation Reversal

By Jessica Williams

The desire to be pregnant can throw us into an exciting adventure filled with hopes and plans for upcoming parenthood. But for women whoundergo tubal ligation, more commonly known as having your "tubes tied," the desire to become pregnant can mean opening a door that wasonce permanently closed.

Tubal Ligation is notoriously performed directly after childbirth, while mom is still in the hospital. Unfortunately, some of the women who were undecided about this birth control method when they went into labor became quite sure that they wanted to be sterilized once they experienced a difficult birth. With labor fresh in their minds, they have the operation. But imagine the tragedy that bestows a woman who loses her newborn after making this rash decision. Or, more commonly, as time passes, some women realize they were in no shape to make a permanentdecision.

According to the National Vital Statistics System, in 1995, nearly 25 percent of women who have had a tubal ligation wanted a reversal. Common reasons for this change of heart include the death of a child, the death of a spouse and re-marriage, a change in financial status or, more simply, a change in perspective.

During a tubal ligation, the fallopian tubes are clipped, cut or burned (by electrical current) to ensure that sperm cannot reach an egg released by the ovary. But, some surgeons used to perform a more drastic method of sterilization: they would take the entire fimbriae from the fallopian tube. Fimbriae are the finger-like projections at the end of each fallopian tube. Their purpose is to retrieve the egg that erupts from the ovary at ovulation. When a surgeon takes the fimbriae, the egg has little hope of reaching the fallopian tube. Unfortunately, this procedure could result in an ectopic pregnancy (also known as a "tubal pregnancy"), generally in the abdominal cavity instead of in the fallopian tube. When a woman has lost all of her fimbriae in such an operation, chances of restoring her fertility are next to zero and in-vitro fertilization may be the next step.

Fortunately, many tubal ligations do not involve the fimbriae, but rather the fallopian tube itself. Depending on how much of the tube is damaged from the original operation, a micro-surgeon can attempt to repair the damage and restore fertility. There are many things for the surgeon to consider, however. Here are some of the questions a surgeon will ask before attempting the procedure:

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