Tubal Reversal

Is Tubal Reversal right for you?

Have you had your tubes tied (tubal ligation) after a previous pregnancy and now seek to be pregnant again? Then tubal reversal may be the best way to achieve that.

For a pregnancy to occur naturally, sperm must enter the fallopian tube through the uterus by way of the vagina and cervix (opening to the uterus or womb). The oocyte (egg) is released from the ovary and is picked up from the other end of the tube (ovarian or fimbrial end). When the fallopian tubes are blocked, sperm and eggs are kept apart and fertilization is prevented.

The fallopian tube is a narrow muscular tube arising from the upper corners of the uterus and ending just next to the ovary. The inner tubal lining is rich in cilia, microscopic hair-like projections that beat in waves that move a fertilized egg (embryo) towards the uterus. The fallopian tube is normally about 10-12 cm (4-5 inches) long.

Tubal ligation is the general term for any surgical procedure that blocks the fallopian tubes to prevent pregnancy and is usually intended as a form of permanent sterilization or contraception. Ligation means to apply a ligature or tie. Tubal ligation is often called "tying" the tubes. Frequently, there is a misconception that the fallopian tube has been tied (like a knot) or with a suture or string and that simply removing or "untying" of the knot or suture will open back up the tubes. However, there are many surgical methods used to ligate the tubes which can affect the ability and success of doing a tubal reversal.

After your tubal reversal surgery, you ideally want to end up with as much length of tube as possible. The fallopian tube is not only a channel for egg and sperm to meet, it is also where the fertilized egg has to mature and develop for preparation of implantation into the lining or wall of the uterus. If the fallopian tube is too short, the embryo does not have enough time to mature and pregnancy is less likely to happen. In general, at least 5 cm or greater in tubal length is needed for the best chance for tubal reversal success.

It is very important that we be able to obtain your Tubal Ligation Operative Note dictated by the doctor who performed your procedure. It allows us to see what type of tubal ligation method was performed and the amount of fallopian tube that was removed or damaged. In addition, there may have be other important findings noted such as adhesions (scar tissue), prior tubal damage or other problems that could affect the success rate or even the possibility of doing a tubal reversal.

If the operative note is not available, a diagnostic laparoscopy (placing a small telescope into your abdomen through your belly-button) can be performed to evaluate the amount of fallopian tube that is available. If you are not a good candidate for tubal reversal or if there are other infertility factors involved, In Vitro Fertilization (IVF) may be the preferred method for achieving pregnancy.

Physician Spotlight: Dr. Travis McCoy

Dr. McCoy joined PREG in 2015 and very quickly became the “Go-To” surgeon for the area as well as a fertility expert. His empathy and sincere desire to help couples have families is one of the many reasons his patients adore him. According to Dr. McCoy, “Some of the causes of infertility and recurrent miscarriages can be corrected with surgery without the need for further fertility treatments.” Choosing a surgeon with advanced surgical skills and expertise in restoring or maintaining your ability to get pregnant is extremely important.

All of the physicians at PREG are fellowship trained in Reproductive Endocrinology and specialize in Advanced Minimally Invasive Surgery. Both Dr. John Nichols and Dr. Travis McCoy perform Advanced Robotic Surgery. We strive to use the most minimal invasive surgery to produce a shorter recovery time and provide you the best surgical outcome.

Dr. Travis McCoy is a world renowned Robotic Surgeon performing over 600 procedures using the DaVinci Robot and a two time published author. Unlike traditional surgeries, which require a large abdominal incision, Robotic Surgery is can be done with tiny incisions ensuring precision, and less blood loss. These advanced surgical techniques produce a much shorter recovery time and with less post-op discomfort. In fact, many of the robotic procedures are done on an out-patient basis without any hospital stay at all.

Dr. McCoy also enjoys teaching and has mentored numerous residents during his time at PREG. Sharing his knowledge, expertise and helping other doctors comes very naturally for him and when he’s not busy seeing patients or performing surgery, you can find him on the t-ball fields, leading scouts or enjoying quality time with his family.

  • For more information on Dr. McCoy’s robotic surgery, check out his YouTube Channel

Operative techniques in Gynecological Surgery: Reproductive Endocrinology and Infertility.

                                               

      • Associate Editor and author of 9 chapters, and 6 surgical videos.
      • OB/GYN Secrets, 4th ed. Section editor and author of 6 chapters.