Tubal Procedures

Tubal Microsurgery

With a fellowship in advanced laparoscopic and reproductive surgery, I am experienced in microsurgery for tubal repairs, reconstruction, and tubal ligation reversal. Whether you know or suspect that you have tubal damage, or just need expert advice regarding management of subfertility, I will provide the knowledge to support you to make the right decisions about your own health.

Tubal Factor Infertility

The fallopian tubes are part of a woman’s reproductive system. These ducts carry your eggs from your ovary to your uterus, providing a site for sperm to fertilise the egg. Problems with the fallopian tubes can interfere with fertility, a situation known as tubal factor infertility.

Causes of tubal factor infertility include:

  • Previous sexually transmitted infections that result in inflammation and scarring of the fallopian tubes, typically from chlamydia or gonorrhoea

  • Pelvic inflammatory disease, most often caused by a sexually transmitted infection but may also be due to other bacteria or surgical procedures in the pelvic area

  • Being born with an abnormality of the fallopian tubes

  • Accidental damage and/or scarring during previous pelvic surgery

  • Inflammation and scarring from endometriosis

Problems with your fallopian tubes can be diagnosed during my routine fertility testing at your initial appointment. This allows me to personalise my approach to finding the best solution for you.

Treatment for Tubal Factor Infertility

Tubal reconstruction and repairs restore the function of your fallopian tubes. I usually perform these as laparoscopic procedures, as this offers all the benefits of minimally-invasive surgery – less pain, less scarring, shorter recovery, and fewer complications.

A tubal reconstruction or repair may involve:

  • Removing scar tissue that is blocking or distorting your fallopian tubes

  • Taking out damaged sections of the tube and reconnecting the remaining healthy tissue

The associated risks and chances of success will be specific to your body, the condition of the tubes, and the procedure required. I will discuss everything you need to know at your initial consultation so that you can make an informed decision about your own treatment.

Find out more about fertility testing for women

Tubal Ligation

Women who have completed their family may consider a permanent form of female contraception known as tubal ligation, often referred to as “having your tubes tied”. This procedure prevents sperm from reaching the egg. The predominant benefit of tubal ligation over other forms of contraception is that it’s a once-off event that provides extremely effective birth control long-term. You no longer have to remember to take a daily pill, and there are no hormonal side effects to contend with.

Tubal ligation isn’t for everyone. As your fertility specialist, I am committed to helping  you to find the right contraceptive solution for your goals, personal preferences, and lifestyle.

This minimally-invasive laparoscopic procedure is performed under general anaesthesia. Small  “keyhole” incisions are made in your abdomen to provide access for the laparoscope, a long, thin camera, and the tools used to perform the ligation.

There are several different types of tubal ligation:

  • Applying a clip to seal off the tube

  • Tying off part of the tube

  • Cutting and removing part of or all of the tube

After your tubal ligation you can go home on the same day. Recovery is quick, and most people are back to normal activities in 1-2 weeks.

 Risks of Tubal Ligation

Though tubal ligation is one of the most effective forms of contraception, it is not quite 100% effective. On rare occasions (less than 1% of cases) a woman may still fall pregnant after having had a tubal ligation.

Other risks and complications include:

  • Allergy to the anaesthesia

  • Infection, bleeding, and pelvic cramps

  • An increased risk of a tubal ectopic pregnancy (where a fertilised egg implants in the fallopian tube) if you accidentally fall pregnant.

Tubal Ligation Reversal

Despite tubal ligation being designed as a permanent form of contraception, it is possible in many cases to reverse and restore your ability to conceive. Not all cases of tubal ligation can be effectively reversed; this will depend on the method used to perform the initial operation and the current condition of your fallopian tubes.

Tubal ligation reversal is performed laparoscopically with small, “keyhole” incisions. Any clips or stitches are removed, the damaged portions of the tube are removed, and the healthy ends are reconnected.

Similar to the tubal ligation procedure, the reversal operation is done under general anaesthesia. Its minimally-invasive nature means you benefit from a faster recovery with less pain, less bleeding, and lower risk of complications.

Conceiving after tubal ligation reversal

It’s important to remember that a successful reversal of tubal ligation doesn’t guarantee the ability to conceive or have a successful pregnancy. Conception and pregnancy are affected by many factors, including those associated with the partner providing the sperm. Roughly 50% of women successfully conceive after a tubal ligation reversal.

It is normal to take many months to conceive naturally after having had a tubal ligation reversal. If there are other factors interfering with pregnancy, I will investigate and address these as needed. For instances where the tubal ligation reversal procedure hasn’t enabled you to conceive naturally, you still have options for growing your family, including IVF and other assisted reproductive techniques.

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Tubal Microsurgery with me

Whether you’re considering tubal ligation for contraception, a tubal ligation reversal, or need expert advice in overcoming tubal factor infertility, I can help. My approach is always practical, evidence-based, and compassionate, because I know the information out there can be overwhelming and often confusing. Plus, my advanced training in laparoscopic and reproductive surgery means you’re in good hands.

FAQs

  • Because your body will need some time to heal after having the reversal procedure, I usually recommend allowing at least two menstrual cycles before you start trying to conceive. Remember that your chances of falling pregnant after a tubal ligation reversal will be affected by other factors, including your age, egg quality, ovarian reserve, and overall health.

  • Women who are considering tubal ligation are those who are sure they have completed their families and don’t wish to have any more children. However, understandably, some women may have concerns about having a surgical procedure. Although tubal ligation is a very effective, convenient, and low-risk method of birth control, there are other effective options with their own pros and cons. You may consider hormonal implants, intrauterine devices, injections, oral contraceptive pills, or a vasectomy for your partner.

  • As with any surgical procedure, there is a risk of bleeding, infection, or pelvic pain, though these are uncommon. Women who have had a tubal ligation reversal are at a slightly increased risk of an ectopic pregnancy, which is an emergency, but this overall risk is still low.