If you want to get pregnant after ligation, you can do tubal anastomosis or IVF.
In fertility appointments, there are some women who want to get pregnant after ligation. The reasons are usually remarriage, children passed away by accidents or want to add a new family member after having children several years. There are only two ways to get pregnant after fallopian tubes are ligated. The first is to do tubal anastomosis, and the second is to do IVF. However, these two ways are both not easy, so think twice before you do ligate.
Performing tubal anastomosis and reconnecting fallopian tubes is the first option for most people. The cost of using conventional ways to do tubal anastomosis is cheaper than IVF, and furthermore, complicated IVF treatment can be avoided. By doing this way, couples can try to get pregnant every month after the operation. This idea is correct, but there are many more subtle aspects that require careful consideration. Women who are suitable for this operation must first exclude the factors of male infertility (in simple terms, the semen analysis must be normal).
After the male infertility factors are excluded, the factors that affect successful pregnancy under fallopian tubes reconnection are as follows:
1.Female age
Regardless of the treatment, the age of the woman is always the most important factor in determining the success of the pregnancy.
Studies have pointed out that without male infertility factors, women who are with normal ovarian function and had done fallopian tube reconnection before the age of 35, have a cumulative live birth rate of 70%. Most of them can successfully become pregnant within 12 months after surgery. On the other hand, for those who complete fallopian tube reattachment surgery after 35 years old, the cumulative live birth rate is about 50%.
2. The remaining fallopian tube length after ligation
After reconnection, the length of the fallopian tube must be at least 5 cm long to maintain good physiological function. The length from the ampulla to the infundibulum should be at least 3 cm, and the isthmus needs 2 cm.
A study about the length of the fallopian tube and the time required for a successful pregnancy after surgery pointed out that if the fallopian tube is over 6 cm long after surgery, most women can get pregnant within 5 menstrual cycles after surgery. If the fallopian tube is shorter than 4 cm after the operation, it takes an average of 19.1 months for a successful pregnancy.
3. Surgical technique
Good surgical technique and quality are also one of the key factors for a successful pregnancy, and it can reduce the chance of ectopic pregnancy.
4.Select suitable patients
Exclude partner’s male infertility factors, it is necessary to review the surgical records of the fallopian tube ligation (check if any record of the pelvic cavity situation and the remaining fallopian tube length at the time), and do hysterosalpingogram again to evaluate the remaining fallopian status and length.
Based on the above discussion, in simple terms, it is suggested to do IVF directly for women who still want to get pregnant after ligation with situations such as advanced age, low ovarian preservation, male infertility, and have time pressure. Fallopian tubes reattachment surgery is more suitable for those who have financial consideration, with young ovaries and no heavy fertility pressure. However, it is recommended that every woman discuss with a professional infertility doctor before making the choice, it will be easier getting pregnant again.
P.S. Generally speaking, the cost of conventional fallopian tubal anastomosis is lower than IVF. However, the cost of reconnecting the fallopian tube through advanced laparoscopic surgery or Da Vinci surgery may be higher than IVF.
Reference：
Tubal anastomosis after previous sterilization: a systematic review
Jacoba A H van Seeters et al. Hum Reprod Update. 2017.
