Around 600,000 women in Spain undergo tubal ligation in order to avoid having more children. However, between 10% and 15% of these wish to have a child at some later point owing to various personal circumstances. Some opt for this using assisted reproduction, unaware that this ligation may be reversible by microsurgery, that it achieves more pregnancies than assisted reproduction, and is cheaper in economic terms (Read HERE figures os sterilisation in USA) .
The microsurgery technique used to reverse the procedure has an average pregnancy success rate of 55%, exceeding 70% in women aged under 35 years.
The success of the intervention depends on various factors. The first is age: over age 40 years, the success rates for conceiving a child are much lower; in women aged under 35 years, the pregnancy rates range from 70% to 85%; and the intervention is not performed in women aged over 50 years.
Secondly, it is important to assess how the tubal ligation was performed. If the tube or distal part of the tube (the fimbriae) have been removed, the intervention cannot be performed.
It is also important that a certain tube length has been preserved — at least 4 cm — otherwise they lose functionality.
Tubal ligation reversal has another advantage, in that there are no limited treatment periods (as in in-vitro fertilisation for example), since the conception occurs naturally and the risk of multiple pregnancies is avoided. Once the problem has been resolved, the patient can choose to have as many pregnancies as she wishes, without requiring any further procedures. Conversely, there is a 10% higher risk of an ectopic (extrauterine) pregnancy.
The surgery lasts for an hour and a half, and is carried out under general anaesthetic with the aid of a microscope. The tied area is removed and the two ends are sewn with invisible sutures. The incision is closed and saline filtered through the uterus and tubes to check that the obstruction has been completely cleared. The patient is discharged the following day (José Ángel Minguez Milio. Clínica Universidad de Navarra. 13-01-2015).