Tubal Reversal

• Tubal reversal is a very successful procedure done to restore fertility after a decision is made to undergo tubal ligation. Tubal ligation is regarded as a permanent and irreversible method of contraception but the good news is that it can be reversed by using sophisticated microscopic surgery.
• Research has shown that 24% of Australian women have tubal ligation as their preferred method of contraception. Many will regret this decision with the most common reason for this is change of heart being a new relationship and a desire to have further children.
• If you have been thinking about tubal reversal, the first step is to assess whether you are a candidate for this procedure. Some of the important factors to consider are age, the type of tubal ligation (e.g. tubal clips or rings) and the health of your partner’s sperm. To gain a thorough assessment of each of these issues consultation with a Fertility specialist is necessary to provide you with accurate and reliable evidence to support your decision for tubal reversal.
• Dr Elzeiny is a fertility specialist with considerable expertise in microscopic tubal reversal. Dr Elzeiny offers a unique tubal reversal procedure which involves only a small incision in the lower abdomen. The small incision ensures minimal operating time under general anaesthetic, a quick recovery and only a short hospital stay.
• Tubal reversal is a procedure that takes one to one and a half hours compared to the usual 2-3 hours of traditional surgical methods. A small incision is created of approximately 3-4 cm on the crease of the lower abdomen. This small incision means that there will only be a small hidden scar after the procedure.
• During the procedure, the tubes are cut around the blockage site and the inner layer of the tubes are re-joined using suture material that is about 1/3rd the thickness of human hair. This step is performed under microscope to ensure the accurate and precise approximation of the cut ends of the fallopian tubes. Once complete, the outer layer is closed and the same process is repeated on the other side. At the end of the procedure, a dye is injected from the uterus to test the success of the tubal reversal. In a successful procedure, the dye is able to successfully move from the uterus through the fallopian tubes.
• No placement drains underneath the wound are necessary and no metal retractors are also, reducing post-operative pain. Women are usually fit to go home within a day or 2 of the surgery.
• Couples may try to become pregnant following the 2nd menstrual period following the tubal reversal procedure.
• Given that the procedure is performed on the fallopian tubes, once couples have tested positive for pregnancy a blood test will need to be check that the pregnancy has successfully implanted into the uterus. This test is important as there is a slightly increased chance of ectopic pregnancy following a tubal reversal. This blood test allows us to exclude this risk.
• The patency rate (success rate) of re-joining the fallopian tubes successfully is near to 99%. This success however is dependent in the skill of the surgeon. In the absence of any other fertility issues, the pregnancy rate following tubal reversal approaches 80% in the appropriate age group.
• Medicare Australia has recently reintroduced item numbers for tubal reversal, reducing the out of pocket expense associated with the procedure.
  Dr Elzeiny’s fees are based on the recommended fees of the Australian Medical Association and are very competitive.
• A substantial portion of these fees are rebatable from the combination of rebates available via Medicare Australia and our private health insurance fund. The size of your rebate will depend on the type and level of private health cover.
• Dr Elzeiny has performed countless tubal reversals and is considered an expert in this field. He is committed to providing only the highest quality of care to all of his patients. His approach to tubal reversal is unique, safe and minimised the inconvenience and recover time of the procedure.

Please do not hesitate to contact Dr Elzeiny’s rooms for more information or to organise a consultation for professional advice.

Tubal occlusion is a sterilization procedure for women desiring not to become pregnant in the future.

Fallopian tubes, located on either side of the uterus, pick up eggs released from the ovaries and transfer them to the uterus. If these tubes are blocked, sperm fail to reach the eggs and fertilization will not occur. Laparoscopic sterilization is a technique of tubal ligation to block or close the fallopian tubes, the pathway for sperm to reach eggs for fertilization.

Tubal reversal or reversal after sterilization of the fallopian tube is a surgical procedure to restore fertility by restoring the normal functionality of the fallopian tubes that were blocked during sterilization. About 5-10% of women may require reversal of sterilization as they desire to have more children. Women whose tubes were removed during the sterilization cannot have a reversal.

The major factors that may affect the results of tubal reversal are as follows:

• Age
• Condition of the tubes
• Regularity of the menstrual cycle
• Fertility of partner
• Problem with other part of the reproductive system

Prior to the reversal surgery, patients should undergo a screening that includes a physical examination, medical history, series of laboratory tests, review of the medical reports of sterilization methods and evaluation of the partner’s fertility.

Tubal reversal procedures are performed on an outpatient basis under general anaesthesia. Your surgeon first places the laparoscope into the pelvis area through the belly button to observe the fallopian tubes. If the surgeon finds a possibility of reversal surgery, a small incision is made near the pubic hair line and a laparoscope is inserted. Any rings or clips that block your tubes are removed with the help of the instruments attached to the end of laparoscope. The ends of the tubes are then reconnected to the uterus with stitches.

As with any procedure, tubal reversal also involves certain risks and complications which include infection, bleeding, scarring of the tissue and chances of ectopic (tubal) pregnancy.