Undoubtedly, when you are faced with the deeply personal decision of how to grow your family after tubal ligation, it’s natural to feel uncertain. Sometimes, even overwhelmed! Here are the two most successful options that come with ultimate hope—tubal ligation reversal and IVF.
Where IVF involves fertilizing the eggs outside the body, tubal ligation reversal restores the fallopian tubes to allow natural conception. However, each option has its own benefits and considerations. Today’s comprehensive comparison guide will help you to weigh these factors and make a well-informed decision based on facts. Just read on.
What is IVF?
In-vitro fertilization, aka IVF, is one of the many techniques that help women with fertility problems to have a child. In this procedure, the egg is combined with sperm “in vitro”, which means “in glass”.
In the quick rundown below, let’s try to understand the in-vitro fertilization process.
Step 1: Birth control pills or estrogen
Before starting the IVF procedure, birth control pills or estrogen are prescribed. It is done to regulate your menstrual cycle and to stop the development of ovarian cysts. It helps your doctor time the cycle and enhance the egg quality.
Step 2: Ovarian stimulation
During your IVF cycle, you’ll take hormone injections to stimulate your ovaries. It’ll help to mature multiple eggs instead of just one. Your doctor will monitor the response and track the follicle growth with blood tests and ultrasound over 8-14 days. When the eggs are ready, a ‘trigger shot’ is given exactly 36 hours before egg retrieval to finalize egg maturation.
Step 3: Egg retrieval
Your healthcare provider guides a thin needle into each of your ovaries through your vagina to collect mature eggs. In this procedure, mild sedation is used. The procedure is generally done 36 hours after the trigger shot.
Step 4: Fertilization
Mature eggs are fertilized using ICSI (intracytoplasmic sperm injection). That means sperm is injected directly into the egg. Generally, on average, 70% of eggs are fertilized—if you have 10, about seven may become embryos. If there is a large number of eggs or you don’t want all to be fertilized, extra eggs can be frozen before fertilization for future use.
Step 5: Embryo development
Fertilized eggs develop over 5–6 days. About half of the embryos reach the blastocyst (a rapidly dividing ball of cells) stage, which is ideal for transfer.
Step 6: Embryo transfer
Your doctor will use a thin catheter to insert a fresh or frozen embryo into your uterus. It’s a quick procedure, takes less than 10 minutes, and is typically painless.
Step 7: Pregnancy
Pregnancy occurs if the embryo implants itself into the lining of the uterus. It is confirmed through a blood test 9 to 14 days after embryo transfer.
What Is Tubal Ligation Reversal?
Tubal ligation reversal, aka TLRS, is a surgical procedure that helps to restore fertility in a woman who has previously undergone tubal ligation (a tubal sterilization procedure that prevents pregnancy).
TLRS is an outpatient procedure. The healthcare provider at the fertility clinic gives general anesthesia before the surgery. The surgeon makes a small cut near your belly button and inserts a small lighted scope called a laparoscope.
Through it, they check the condition of your fallopian tubes. If the reversal surgery is possible, the surgeon uses a tiny tool attached to the end of the laparoscope to remove any clips or rings blocking your tubes. Then, the remaining fallopian tube segments are reconnected to allow natural conception.
What’s the Real Difference Between IVF and Tubal Ligation Reversal? Quick comparison
Here is a simple side-by-side comparison between IVF and tubal ligation reversal. It will help you understand the real differences in both procedures—without overwhelming you with too much info.
| Traits | In-vitro Fertilization/ IVF | Tubal Ligation Reversal |
| 1. Procedure overview | Eggs and sperm are fertilized outside the body, and then the fertilized egg is directly transferred to the uterus. | Fallopian tubes are reconnected to allow natural conception |
| 2. Procedure steps | Multiple steps including Birth control pills or estrogenOvarian stimulationEgg retrievalSperm collectionFertilizationEmbryo developmentEmbryo transferPregnancy | Single surgical procedure. |
| 3. Procedure duration | Several weeks | 1 to 2 hours |
| 4. Invasiveness | Less invasive. Involves minor surgical steps and laboratory procedures | Comparatively more invasive as it’s a surgical procedure. |
| 5. Recovery time | A day or two | A week or two. |
| 6. Time to pregnancy | One to two weeks following the egg retrieval process, a blood test is done to determine pregnancy. | Within the first year or two following tubal ligation reversal. |
| 7. Chance of natural conception | Does not involve natural conception; embryos are implanted directly. | Allows for natural conception post-procedure. |
| 8. Medication or hormone requirement | Yes | No |
| 9. Multiple pregnancies | No | Yes |
| 10. Ectopic pregnancy | Yes | Yes |
| 11. Success rate | 30% per cycle | Up to 85% |
| 12. Ideal age | No universal age limit, ideal age late 20s to early 30s | No age restriction, women younger than 35 have a higher success rate |
| 13. Eligibility | Suitable for a wider range of fertility challenges. | Suitable for women with previously ligated tubes. |
| 14. Preferred option | Women who require advanced fertility assistance, have damaged or blocked fallopian tubes, or have other fertility issues. | Women who desire natural conception |
| 15. Risks | Ovarian Hyperstimulation Syndrome (OHSS), multiple births, miscarriage for older women | Bleeding, infection, and damage to other organs, ectopic pregnancy. |
| 16. Cost | $10,000 to $30,000+ | Thousands less |
| 17. Insurance coverage | Covers vary based on insurance plans and state | Generally does not cover |
| 18. Ethical dilemmas | Yes | No |
Tubal Ligation Reversal Success Rates
Tubal ligation reversal offers higher chances of natural pregnancy. Here, the success rate ranges between 40% to 85%. However, the success rate depends on factors like the age of the woman and the type of tubal ligation performed.
| Age Group | Tubal Ligation Reversal Success Rate |
| Women under 35 | 60% |
| Women aged between 35 to 37 | 40% |
| Women aged between 38 to 40 | 30% |
| Women aged 41 to 42 | 20% |
| Women over 42 | 10% |
Moreover, pregnancy can be achieved after all types of tubal ligation reversal, including clips, rings, Essure removal, or reversal. However, the chance of pregnancy is higher with the reversal of tubal clips and tubal rings. Let’s have a quick overview of the pregnancy rate after different types of tubal ligation reversal.
Chances of pregnancy after tubal ligation reversal
| Method | Pregnancy Rate |
| Clips | 78% |
| Rings | 76% |
| Ligation/Resection | 66% |
| Coagulation | 66% |
| Essure | 32% |
| Other/unknown | 52% |
IVF And Success Rates
As the fertility rates tend to decline with age, in vitro fertilization follows the same pattern in terms of success rate. IVF has a higher success rate below the age of 35, but over the age of 35, the success rate significantly declines. It happens more sharply after 40.
| Age Group | Overall Live Birth Rate | Live Births (First Embryo Transfer) | Live Births (Later Embryo Transfers) |
| Women under 35 | 55.6% | 41.4% | 47% |
| Women aged between 35 to 37 | 40.8% | 31.6% | 44.7% |
| Women aged between 38 to 40 | 26.8% | 22.3% | 40.9% |
| Women over 40 | Around 7% | – | – |
How Soon Can You Expect Results?
As for the IVF procedure, you can expect to take a pregnancy test around 10 to 14 days after the embryo transfer. Typically, an IVF cycle takes around 6 to 8 weeks. Initial consultation followed by ovarian stimulation lasts 8 to 14 days. Then, egg retrieval, fertilization, and embryo transfer to the uterus are done. Embryo transfer is done 5 days after fertilization.
On the other hand, in tubal ligation reversal surgery, it can take close to 2 years for the patient to become pregnant after a successful surgery. Many patients tend to term this waiting period pretty long and continue to remain anxious about the results.
However, many women find deep emotional fulfillment in conceiving naturally through tubal ligation reversal. It makes the waiting more meaningful around personal and ethical values.
Are There Any Risks You Should Know About?
With the IVF procedure, complications are rare. But they do exist. One of the most common ones is Ovarian Hyperstimulation Syndrome (OHSS). It generally happens when the ovary responds too strongly to fertility medications. It can affect around 10% of IVF patients. Another possible complication can be bleeding during egg retrieval and infections. They can occur in about 1 in 3,000 and 1 in 6,000 cases, respectively.
Tubal ligation reversal also comes with risks, but that is also a very rare case. These include infection, bleeding, or complications from anesthesia. The biggest concern for the reversal is the risk of ectopic pregnancy (fertilized egg implants outside the uterus, most often in the fallopian tubes). However, ectopic pregnancy can happen in about only 2% to 7% of cases.
What About the Cost?
Typically, the cost for the tubal ligation reversal surgery depends on the type of tubal ligation being reversed, the surgeon’s experience, additional medical fees, the clinical setting you choose, and the relevant complexities. However, on average, you can expect to pay around $8,685. Depending on what tests you will need, the cost can range between $5,000 to $21,000.
Extra Costs For Testing
Below are some extra costs you can expect in the tubal ligation reversal procedure for the necessary tests.
| Lab Tests | Potential Costs |
| Semen analysis | $100 |
| Ovarian reserve testing with the lab | $285 |
| Confirmation of ovulation lab | $95 |
| Evaluation of uterus & ovaries with ultrasound | $300 |
| HSG | $1500 |
[Note: These are the potential costs for the tubal ligation reversal and some probable tests. It’s just for a rough idea. It is not written on the stone.]
As for the cost of in vitro fertilization, you can expect to pay around $15,000 to $30,000 or more. Moreover, IVF requires daily injections, ultrasounds, and many blood tests, 6 times per cycle. And here, IVF costs over $15,000 per cycle. On average, IVF requires 2 to 3 cycles for a single pregnancy.
In contrast, tubal ligation reversal only requires a maximum of 3 visits. Even if the health insurance covers parts of the cost for the test in IVF, one cycle of IVF is far more expensive than the tubal ligation reversal surgery.
When IVF Becomes A Recommended Solution?
So, who can benefit from the IVF? Beyond the basic requirement for in vitro fertilization, it is really a question of the individual’s situation. IVF can be effective for many people dealing with a range of fertility issues. Below is the list of people or couples who might be good candidates for IVF.
- Couples who have been trying to conceive for more than 6 months
- Have not had success with simpler treatments like fertility medications, IUI, or Intrauterine Insemination.
- Facing an age-related decline in fertility or low ovarian reserve.
- Have experienced multiple miscarriages.
- The couple carries a history of or is at risk of passing a genetic condition or disorder.
- Have conditions that affect fertility. For instance, PCOS or polycystic ovary syndrome, endometriosis
- Have low sperm count or poor sperm quality
- Have blocked, damaged, or missing fallopian tubes.
- Are unable to ovulate regularly or not at all
- Couples dealing with unexplained infertility
When Does Tubal Ligation Reversal Make More Sense?
In certain cases, tubal ligation reversal offers more effective and long-term benefits, especially when natural conception is part of your plan. That is something IVF can’t provide. However, below is the list of people or couples for whom experts of the iTubal fertility center suggest tubal ligation reversal can be a better option.
- Tubal ligation reversal is a natural procedure. It doesn’t require hormone injections.
- You are younger and want multiple children. Tubal ligation reversal will eliminate the need for ongoing fertility treatments.
- Have healthy fallopian tubes with minimal scarring
- Want a cost-effective fertility solution. Tubal ligation reversal is far less expensive than multiple IVF cycles. The procedure is half the cost of IVF.
- Have good reproductive and overall health, no other fertility issues.
- Have a normal sperm count, or there are no male fertility issues
- Couples who desire a long-term solution
- Prefer one-time surgery instead of ongoing monitoring
- People or couples who value the emotional aspect of conceiving naturally.
Ask Yourself: Crucial Things To Consider
After all the comprehensive discussion, it’s time to decide which one to choose. Tubal reversal or IVF? There are a few factors that can make your decision process much easier. Consider the ones below.
I) Goals
If you want multiple children and you are young, tubal ligation reversal can be a better option. However, if you desire only one child and you are older than 35 years old, IVF will probably be the best choice after the tubal ligation.
II) Age
Age is also an important factor in choosing between IVF and tubal ligation reversal. Women under 37 may benefit more from tubal reversal surgery. That is because they will have more time and higher egg quality for natural conception again and again.
They will not require multiple IVF rounds. For women over 37, where declining fertility combines with the higher risk of ectopic pregnancy, IVF offers a safer and more effective route to pregnancy.
III) Time to Pregnancy
After tubal ligation reversal surgery, it takes about 3 months to confirm the success of the surgery. It is done through the HSG (Hysterosalpingogram) test that checks if the fallopian tubes are clear.
From there, the average time to pregnancy is about 2 years. In contrast, pregnancy time is much shorter with IVF. One IVF takes about 2 months to complete. Some women may require multiple rounds of IVF to achieve pregnancy. In more challenging cases, treatment is often completed within a year.
IV) Emotional Considerations
Some women feel more empowered and hopeful when they can try to get pregnant naturally again. Tubal ligation reversal surgery gives you multiple chances to conceive naturally without medical assistance each time. It is something that in vitro fertilization or IVF simply can’t offer.
V) Cost
Tubal ligation reversal surgery and a single cycle of IVF both cost between $10,000 and $15,000. But IVF requires several attempts. In contrast, tubal ligation reversal is one procedure and allows multiple pregnancies without additional costs.
However, all in all, tubal ligation reversal can be the most cost-effective option for women less than 41 years of age. In contrast, IVF will be the most cost-effective option for women aged ≥41 years who desire fertility after tubal ligation.
VI) Male Partners’ Fertility
The male partner’s fertility is also an important factor that can tip the scales. Here, semen analysis is a crucial first step in this process to decide whether to use tubal ligation reversal or IVF.
If the male partner’s sperm health is strong, tubal ligation reversal is a natural and effective path. If the male partner has a low sperm count, IVF can be a better option. IVF can still achieve normal fertilization rates with the ICSI technique. It makes IVF a more reliable option for couples dealing with the male factor fertility.
The Final Takeaway!
The session between IVF and tubal ligation reversal is a highly complex procedure, as they both offer a successful path to parenthood after tubal ligation. On top of that, they are profoundly affected by factors like age, cost, and time of pregnancy, and whether there are any other fertility issues.
If you are hoping for a natural path to pregnancy and long-term fertility, tubal ligation reversal is the better fit. If you are still unsure which option fits your path to parenthood, don’t guess. Get expert guidance. Contact iTubal for a personalized consultation today.
FAQs: Addressing Your Common Concerns!
At this point in the discussion, let’s try to address your common concerns through the queries that people frequently ask.
Can I undergo IVF if I’ve had a tubal ligation?
Yes, you can undergo IVF even after tubal ligation. Here, with IVF, pregnancy can occur as it bypasses the fallopian tube altogether. The fertilized egg is implanted directly in your uterus, allowing pregnancy.
What factors influence the success of Tubal Ligation Reversal?
The success of the tubal ligation reversal depends on a number of factors that decide whether you are a good candidate or not. Such factors include your age, the type of sterilization performed, the health of your fallopian tubes, and whether there are any other fertility issues.
How many cycles of IVF might I need to try before becoming pregnant?
On average, women require 2 to 3 cycles of IVF to achieve a successful pregnancy. Women below the age of 40 have a 65.3% chance of getting pregnant within six IVF cycles. For women 40 and over, chances drop to 1 in 3, even after six cycles. By age 42 and above, the success rate falls below 4%, even with six cycles.
Are miscarriages common after tubal ligation reversal?
According to a study, the chances of miscarriage are around 34% for women under 30. As for women over 40, the chances of miscarriage are about 60%. Typically miscarriage rate after the tubal ligation reversal ranges between 33% and 49%. And with age, the risk of miscarriage increases.
Do your tubes have to be untied for IVF?
No, not necessarily. Your fallopian tubes don’t need to be untied to become pregnant with IVF. This procedure bypasses the fallopian tube entirely. It allows fertilization to happen in the lab and then directly implants in the uterus.
