Family Ties (Tubal Ligation)
What is your ideal family size? Do you feel confident that you will have the same answer in five or ten years?
Women who know with complete certainty that they don't want to get pregnant may opt for a tubal ligation. This procedure (commonly known as "getting your tubes tied") is 99 percent effective. "We counsel women that this is a permanent cessation of fertility," says John F. Randolph, Jr., M.D., professor in the Obstetrics and Gynecology Department and director, Division of Reproductive Endocrinology and Infertility.
The procedure closes the fallopian tubes so that eggs can't travel to the uterus from the ovaries. Many women choose to have the procedure performed during a cesarean section, or the procedure can be done anytime laparoscopically through tiny incisions in the abdomen.
Changing your mind
Research shows that the women who are most likely to want a tubal reversal (reopening the fallopian tubes) are women who were young when their tubal ligations were performed and/or women who were in an unstable relationship at the time. Many women who choose a reversal have a new partner.
| Is post-tubal ligation syndrome real? |
| The physical and emotional effects of tubal ligation have been debated for decades. The term post-tubal-ligation
syndrome (PTLS) describes a variety of symptoms (increased menstrual bleeding and cramps, headaches, irritability and
mood swings) women have reported after tubal ligation, but whether or not PTLS actually exists is still controversial.
Research supports both perspectives. In 2005 BioMed Central published a study which concluded that tubal sterilization does not cause menstrual irregularities. A more recent study by Gary Sterling Berger, M.D., published in the Society of Reproductive Surgeons newsletter, found that 90 percent of patients reported improvement in PTLS symptoms after tubal reversal. Berger's study also concluded that further research is warranted. |
The success rate for reversals ranges from 20 to 70 percent. It is impacted greatly by the method of the original tubal ligation (cut, tied, burned or clamped), how much tube is left and the woman's age at the time of reversal.
Weighing your options
All of these factors can be discussed with your doctor. Randolph says that if a woman or her partner have any additional problems that would lower their chances for a successful pregnancy-for instance, if the man has low sperm count or the woman is older than 35-then they might consider in vitro fertilization (IVF). (See Glossary) If a tubal reversal doesn't work, IVF could still be an option.
Reversal used to be a major operation, but now it can be performed as outpatient surgery using minimally invasive techniques such as laparoscopic surgery. In addition, the University of Michigan Health System is one of the few places in the United States that performs the surgery robotically. Advantages of having the surgery performed via a minimally invasive method include significantly less blood loss, less post-operative pain and scarring, and shorter recovery time with a faster return to daily activities.
A few months after a tubal reversal, women may have a follow-up appointment to make sure the reversal was successful. In some cases, women don't need that follow-up appointment, because they are already pregnant.
Find out more here or by calling 734-763-4323. Check with your insurance provider to see if tubal ligation or reversal is covered.
Reading List
Conquering Infertility: Dr. Alice Domar's Mind/Body Guide to Enhancing Fertility and Coping with Infertility by Alice D. Domar, Ph.D., and Alice Lesch Kelly
What to Do When You Can't Get Pregnant: The Complete Guide to All the Technologies for Couples Facing Fertility Problems by Daniel A. Potter, M.D., and Jennifer S. Hanin, M.A.
Dr. Richard Marrs' Fertility Book: America's Leading Infertility Expert Tells You Everything You Need to Know About Getting Pregnant by Richard Marrs, M.D.
This article appeared in the Oct/Nov 08 issue of the Women's Health Newsletter. Read the issue.
