Definition - What does Tubal Reanastomosis mean?
Tubal reanastomosis is the surgical rejoining of the separated divisions of fallopian tubes performed to restore fertility in women after a tubal ligation. Pregnancy can be achieved in around 80% of women who undergo tubal reanastomosis. Tubal ligation involves surgically tying the fallopian tube/s to terminate a woman's fertility who doesn't have a future desire of childbirth. The only way a woman can regain her fertility following a tubal ligation is via reversal of tubal ligation or tubal reanastomosis. Very rarely, after a tubal ligation, the tubes can reattach spontaneously without any intervention (spontaneous reanastomosis), resulting in a failure to achieve sterilization.
FertilitySmarts explains Tubal Reanastomosis
Fallopian tubes aid in the transport of sperm to the site of fertilization and serve as a conduit for the fertilized egg to travel towards the uterus where it can attach itself to the uterine lining (a process called implantation). When the tubes are ligated or tied, the transport of a fertilized egg or embryo to the uterus is impeded and pregnancy is not possible.
In tubal ligation, the segment of the tube that is emerging from the uterus is separated from the farthest portion of the tube connected to the ovary. Tubal sterilization is a permanent method of contraception with a failure rate of only about 0.7%.
Some women who undergo tubal sterilization regret the decision and wish to resume fertility. This is where the role of tubal reanastomosis comes into play. In this microsurgery, the two separated parts of a fallopian tube are surgically reunited. It is ideally performed in younger women under 39 years of age who are attempting to get pregnant again. Tubal reanastomosis has certain prerequisites as follows:
- Proven infertility secondary to a tubal factor (such as PID damaging the tubes)
- Resected tube segments amenable to reconstruction
- The woman has the capacity to ovulate
- Production of an adequate amount of sperms in the male partner
Tubal reanastomosis cannot be performed in the following conditions:
- Age of the woman is 40 years or older
- Diminished ovarian reserve
- Resected tube segments are not suitable for a surgical reunion (for example, not enough segment length available to be reconstructed)
- Hydrosalpinx with a diameter greater than 3 cm
- A uterine abnormality
- Pelvic adhesions
- The woman suffers from a condition that contraindicates pregnancy or surgery
- Severe male factor infertility
In women whose tubal segments are not suitable for a tubal reversal but they still wish to conceive, in vitro fertilization (IVF) is an ideal alternative.