Is tubal ligation or pomeroy reversible?
Fallopian tube ligation is also known as pomeroy surgery or just pomeroy because of the popular name. This method has been used since 1915 and its name comes from the doctor who developed it Ralph Pomeroy.
However, pomeroy is the simplest method and clinically used by doctors, since tubal ligation has other ways to perform, and each has a different name. In addition, pomeroy is the first practice that began to be used in surgeries as a contraceptive and irreversible method. Over time, the possibility of a reversal for future decisions by women began to be studied.
This method is carried out by women who, by their own decision, consider their family planning satisfied, or decide not to have children (this type of case is rare). Using the canalization of the fallopian tubes, this small surgery can be performed after a delivery or for a planned consultation.
The decision of be mothers again it can arise shortly after, or years later. A new partner, some personal situation or the pleasure of being a mother again can trigger the need to find a method to reverse tubal surgery . Directing a path that must be seconded by the gynecologist, depending on the internal conditions of the tubes.
The percentage of women who after surgery want to relive the experience ranges from 14%, the majority due to a change in their lives that motivates them to be mothers again.
Circumstances are constantly changing, and the patient can turn to a doctor to assess her possibilities. If you have a partner, you will both undergo fertility tests.
Tubal ligation is reversible in some cases, in which the damage has been gradual and allows a re-union of the two parts. There are 3 types of ligatures.
By section or tubal occlusion:
This is the only method where tubal reversal has a 70% success in women with a maximum of 35 years. The doctor is in charge of disabling only a small part of the area that joins the ovaries, and makes the fertilization of the ovum and sperm impossible. There are two types:
- Ligature per section: This method is the pomeroy, where a part of the tube is cut and the ends are tied, sealing the flow zone.
- Tubal occlusion ligation: The tube is blocked with a staple or ring that prevents the passage of genetic material.
It is the simplest method of reversing, because only the material that causes the obstruction must be removed or the tubes are joined again with a major surgery.
Fallopian tube disablement:
This occurs when the tube is removed, making it totally impossible to revert. The reason is that there is not enough material to recanalize the area and rejoin it with the ovaries. When the removal is partial, that is, they keep 4 to 6 centimeters of the tube in perfect condition, the reconstruction method can be tried.
If this is not achieved, the pregnancy is carried out by in vitro fertilization (IVF).
Removal of the fimbriae:
The probability of achieving a pregnancy with this method after reconstruction is 24%. The removal of fimbriae (It is the end of the tubes that connect with the ovary, and are shaped like small tentacles that hold the ovaries in their upper part) consists of cutting the entire end, which lowers the possibility of a successful recanalization.
The small fringes fulfill the function of collecting the mature ovum so that it is transported through the tubes towards the uterus.
The conditions that a patient must meet is that the tubes are in good condition and an occlusion or section of the tubes has been performed to preserve the highest percentage of success. However, each case is different and it is advisable to visit a trusted gynecologist to establish an in-depth study.
The tests that a woman must undergo, in order to know the state of alteration, are fundamentally:
- The Hysterosalpingography : Here the state of the uterine cavity is studied and the chances of success in the patient to become fertile again are determined.
- Laparoscopy: It consists of introducing a small camera that shows the state of the fallopian tubes.
These cases are used only to know the status of the tubes. Additionally, studies should be done to determine the fertility not only of the woman, the couple must also undergo the same examination. In the case of women the tests are, an ultrasound and hormonal study . In the case of man, with a spermiogram their fertility is tested.
The percentage of success after a reconstruction of the fallopian tubes are between the 55% of pregnant pregnancies, Reconstruction surgery can take up to 2.5 hours, while ligation does not exceed 20 minutes in surgery.
In the case of a reversal or a technically impossible case to rebuild, the safe option is the in vitro fertilization , with higher success rates, even patients over 35 years of age can opt for this practice. In fact, many women opt for IVF in the first instance, bypassing the higher level surgery, and ensuring a pregnancy in less time.