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Risks of
Tubal Reversal Surgery

Tubal reversal surgery can be more affordable and more successful than in-vitro fertilization. Tubal reversal surgery performed at A Personal Choice is an extremely safe outpatient surgical procedure. In our experience tubal reversal is one of the safest major gynecologic procedures with the lowest complication rates.

We keep a close eye on our operative complications. When you come to our practice you can be assured you will be getting the best care possible from a team dedicated to providing safe surgery. Our team is focused on our patients’ surgical safety and pregnancy success.

Our complication rates demonstrate surgery at our facility is safe and the risk of any major complication is low.

Tubal reversal complications

  • Blood Transfusion 0%
  • Major surgical site infections <0.5%
  • Minor surgical site infections <2%
  • Early operative/Anesthesia complications <0.5%
  • Unanticipated MD visit after surgery <2%

All patients are evaluated during scheduling for health conditions, which can increase the risk of surgery. Experienced anesthesia providers and nurses who are dedicated to the care of tubal surgery patients care for patients and all surgeries are performed by Dr. Monteith who has over 15 years of surgical experience in a variety of health care settings.

Tubal ligation reversal
Main risk

No surgical procedure or medical treatment is without risk. The main risk of tubal ligation reversal surgery is not surgery, but rather the increased risk of ectopic (tubal) pregnancy. An ectopic pregnancy is any pregnancy, which attempts to implant and grow at any location outside of the uterus. The most common location of an ectopic pregnancy is within the fallopian tube.

Any woman can have an ectopic pregnancy. The risk of ectopic pregnancy in the general population is less than 3%. The risk of ectopic pregnancy is increased after any condition that disturbs the normal function of the fallopian tube. Even when the fallopian tubes are perfectly repaired and open after reversal surgery the risk of ectopic pregnancy is increased.

The chance of ectopic pregnancy after tubal reversal is approximately 10%. If an ectopic pregnancy is not detected early then tubal rupture can occur if the pregnancy is allowed to grow within the tube without treatment.

More information Tubal reversal risks: An easy explanation

Our recommendations after reversal surgery

We propose a several step management plan to monitor our patients for the increased risk of ectopic pregnancy.

  1. We advise our patients to have close follow-up with their local physicians after reversal surgery and before pregnancy occurs.
  2. We will help facilitate our patient’s appointment with their local physician by sending a letter with our recommendations and a copy of the operative report soon after surgery. We will also provide patients with the same information.
  3. We ask patients to report pregnancies to our office as soon as they are detected.
  4. We encourage patients to see their local doctor soon after they detect pregnancy in order to begin early pregnancy monitoring.
  5. We recommend an early vaginal ultrasound as soon as the early pregnancy monitoring suggests a pregnancy should be visualized.
  6. If early monitoring diagnoses an ectopic pregnancy then we recommend medical treatment with Methotrexate medication, which can minimize the risk associated with ectopic pregnancy.

Early pregnancy monitoring
Decreasing risk of ectopic pregnancy

The best way to determine the location of an early pregnancy is with blood testing for the pregnancy hormone (quantitative serum HCG). Using this testing the location and health of an early pregnancy can often be determined before a pregnancy is seen during an ultrasound exam.

We recommend monitoring your early pregnancy with quantitative serum HCG blood tests every 48 hours and having a vaginal ultrasound exam when your HCG (pregnancy hormone) level reaches 2000. This testing should be started soon after you first detect pregnancy and can be stopped as soon as the location of the pregnancy is determined.

When the pregnancy hormone level reaches 2000, a vaginal ultrasound exam will show a gestational sac (early pregnancy) within the uterus in a normally developing intrauterine pregnancy.

If your ultrasound exam does not reveal a pregnancy inside your uterus, you should have a repeat HCG level and have another vaginal ultrasound exam within 2 or 3 days. Sometimes the early pregnancy may not be seen until HCG level is about 2500 depending upon the quality of the equipment and experience of the person performing your ultrasound examination.

If the early pregnancy is not seen inside the uterus when the HCG level is above 2000, then the pregnancy is abnormal and likely to be either a tubal pregnancy or a pregnancy that will eventually miscarry.

Because the risk of tubal pregnancy is approximately 10-15% after tubal surgery, it is important to notify your obstetrician-gynecologist and follow the Early Pregnancy Monitoring protocol to determine the location and health of the early pregnancy.

A tubal pregnancy cannot lead to a live birth and must be treated. Following the recommended Early Pregnancy Monitoring Protocol is the best way to minimize the risk of tubal rupture, preserve the health of your fallopian tubes, and avoid surgery to remove the tubal pregnancy.

Reason for early pregnancy monitoring

The rationale for early pregnancy monitoring is to prevent a tubal pregnancy from progressing to the point of rupturing the fallopian tube. Rupture of the fallopian tube results in internal bleeding and requires emergency surgery, often resulting in loss of the fallopian tube. In the absence of ultrasound evidence of an intrauterine pregnancy, early treatment with Methotrexate is recommended to end the tubal pregnancy pregnancy. After Methotrexate administration, serum HCG levels should be monitored until the HCG level returns to less than 10 mIU/dL.

Early pregnancy monitoring: Key concepts

The key concepts to understanding HCG pregnancy hormone testing and ultrasound exams are:

  • In a normal pregnancy the HCG levels should double every 48 hours
  • In a normal pregnancy the pregnancy should clearly be seen inside the uterus when the HCG level is above 2000
  • If the HCG levels are not doubling or the pregnancy is not seen inside the uterus when the HCG levels are above 2000 then the pregnancy is abnormal, possibly in the fallopian tube, and will not lead to a live birth

148 thoughts on “Risks of Tubal Reversal Surgery”

  1. Colleen says:

    Hi, I had an ectopic pregnancy before 20 days. One tube and ovary was removed. The other tube was ligated (tied and cut)during that time without informing. I do want to conceive further so is tubal reversal surgery an option to consider with only one tube? Is it true that I’ll 100% be a patient for ectopic pregnancy again ? Is there ways to avoid ectopic?

    1. Dr. Monteith says:


      After tubal reversal there is a 10% chance of ectopic pregnancy.

      We may be able to reverse one tube. With one tube you can become pregnant. When two tubes are reversed patients become pregnant within 12 months. With one tube reversed it could take 12 to 24 months to become pregnant but pregnancy is definitely possible.

      You should send us your tubal ligation reports for a free review and we can let you know if you are a candidate for reversal surgery. Your reports can be obtained from the medical records department where your tubal ligation surgery was performed.

      We charge $6400 total plus $125 to schedule and we are located in Raleigh, North Carolina.

      Please be aware that starting April 1st 2019 the fee for reversal surgery will increase to $6,900 and the scheduling fee will increase to $150. If you want to avoid the higher fees then you should schedule your surgery before April 1st or start a Reversal Prepayment Account.

      Patients pay in full and out-of-pocket at the time of scheduling. All you have to pay for in addition to the surgical fee is the cost of travel, hotel, and food.

      On average the chance of pregnancy after tubal ligation reversal is about 60% if you are under age 42.

      We do have a prepayment tubal reversal plan that allows you to save towards your reversal over a 3 year period.

      Although $6,400 seems expensive…the alternative treatment in-vitro fertilization (IVF) average $12,000 to $14,000 and is about 40% successful!

      The main advantage to tubal reversal is that every month you have a chance and you can become pregnant more than once.

      The following link will answer most of your questions about reversal. This is the MOST HELPFUL INFORMATION to read when considering reversal at our office. Each question has a link to more information about the question:

      Frequently asked questions about tubal reversal

      Call us at (919) 977-5050 8am to 5pm eastern standard time and we would be happy to speak with you about tubal reversal at our facility.

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