Most people are not aware that tubal ligation - usually considered a permanent method of birth control - can be reversed through one hour outpatient surgery. This article reports the outcomes of a large population of women who have had tubal ligation reversals at Chapel Hill Tubal Reversal Center. This is the largest and the most detailed follow-up study of tubal reversal patients in existence.

The study population consisted of 2692 women who underwent tubal reversal surgery between January 2001 and December 2004 . This method of following a group of individuals over time looking for specified outcomes is called a prospective cohort study.

The tubal reversal operations were performed using surgical and anesthetic techniques developed by Dr. Gary Berger. These techniques minimize pain, bleeding, operation time, and post operative recovery time. The surgical techniques, as well as the entire outpatient procedure, are explained step-by-step in a video of outpatient tubal reversal that has been shown in the series called The Operation on Discovery and The Learning Channel.

During the follow-up study interval after tubal reversal surgery, 1,783 (65%) of the 2,692 women had reported pregnancies. Younger women had higher pregnancy rates than older women. The pregnancy rate after surgery ranged from 77% for women under 30 to 34% for women over 40 years of age and older.

Tubal reversals of tubal ring or clip procedures were the most successful, followed by coagulation and ligation/resection procedures, but the differences in pregnancy rates for the latter two methods were relatively small.

The fallopian tube lengths remaining after a tubal ligation procedure are important determinants of the success of tubal reversal surgery. Women with longer tubal lengths had significantly higher pregnancy rates than women with shorter tubes following tubal reversal. Women with tubal lengths 7.5 cm or longer had a pregnancy rate of 77%. The pregnancy rate declined as tubal length decreased, but even women with the shortest tubes (less than 2.5 cm) became pregnant (24%).

Long tubes were also associated with better pregnancy outcomes than short tubes. Among women with average fallopian tube lengths measuring 7.5 cm or longer, 59% gave birth or had an ongoing pregnancy. Birth/ongoing pregnancy rates declined while miscarriage and ectopic pregnancy rates increased with shorter tubal lengths. The ectopic pregnancy rate after tubal reversal is higher than the 2% ectopic pregnancy rate in the general population.

On the Internet, claims about tubal reversal pregnancy rates are often made without supporting information or documentation - such as a description of the patient population, study method, and follow-up interval. Most internet sites about tubal reversal do not provide any factual data at all. Any doctor may say that his patients have a particular success rate, but supporting the claim with actual data involves considerable effort. Performing a follow-up study such as this one requires keeping an accurate record of patients and their findings, as well as maintaining ongoing patient contact to determine the outcomes of treatment. That is the only way a doctor can actually know what the pregnancy and outcome statistics are for his patients.

At Chapel Hill Tubal Reversal Center, nurses enter information into an electronic patient database at the patient's registration, the surgical procedure, and from regular post-operative communications with our staff. If we have not heard from patients after their recovery from surgery, our nurses contact them at 6 and 12 month intervals. We know of no other doctor, hospital, or clinic that maintains such ongoing patient follow-up records after tubal reversal surgeries.

Chapel Hill Tubal Reversal Center 2006