Tubal Ligation Reversal: Procedure, Success Rates, Risks, and Recovery
Updated: 5 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is tubal ligation reversal?
Tubal ligation reversal is a surgery that reopens or reconnects the fallopian tubes after tubal ligation so conception can happen again. It takes two to three hours under general anesthesia, usually with same-day discharge. Between 5 and 8 in 10 women become pregnant afterward, though about 4 to 8 in 100 women have an ectopic pregnancy. [1][2]
What the research says
Most women conceive after surgical reversal. A systematic review of 37 studies covering 10,689 women found pooled pregnancy rates of 42–69% after sterilization reversal, with ectopic pregnancy reported in 4–8%. (van Seeters et al., Human Reproduction Update, 2017) [2]
Age is the strongest predictor of success. In 93 women treated laparoscopically, 95.7% aged 27–35 had a positive pregnancy test, compared with 36.4% aged 43–47; across all ages, 75.3% became pregnant and 52.7% delivered at term. (Godin et al., Frontiers in Surgery, 2019) [3]
Tube length and time since ligation also matter. An analysis of 156 laparoscopic reversals found higher pregnancy rates in women under 35, in those whose ligation was less than 6 years earlier, and in those with more than 7 cm of remaining tube. (Feng et al., BMC Pregnancy and Childbirth, 2019) [4]
Key takeaways
Tubal ligation reversal reconnects the fallopian tubes so an egg and sperm can meet again. [1]
After tubal ligation, the only two routes to pregnancy are reversal surgery or in vitro fertilization (IVF). [1]
Reversal isn't possible if too little healthy tube remains or the tubes were blocked with certain implant devices. [1]
Age has the biggest effect on success; the surgical method itself makes little difference. [2][3]
Most people return to normal activities within two weeks and wait two menstrual cycles before trying to conceive. [1]
Tubal ligation reversal at a glance
Feature | What to expect |
Other name | Tubal reanastomosis |
Purpose | Reopen the fallopian tubes so natural conception can happen |
Setting | Hospital, usually home the same day |
Anesthesia | General (you are fully asleep) |
Surgery time | About 2–3 hours |
Approaches | Mini-laparotomy or robotic-assisted laparoscopy |
Back to normal activities | Within about 2 weeks |
Full recovery | About 4 weeks |
When to start trying | After 2 menstrual cycles |
Pregnancy rate | Between 5 and 8 in 10 women |
Main extra risk | Higher chance of ectopic pregnancy (about 4-8%) |
Insurance | Often not covered |
How does tubal ligation reversal work?
Tubal ligation reversal works by opening the blocked ends of the fallopian tubes and joining the healthy segments back together. [1]
Tubal ligation, often called "having your tubes tied," prevents pregnancy by closing off the fallopian tubes. Reversal undoes that block.
Once the tubes are open again, an egg can travel through them and meet sperm. That makes natural conception possible.
The procedure is also called tubal reanastomosis.
Who is a good candidate for tubal ligation reversal?
A good candidate for tubal ligation reversal is someone whose surgery is likely to help them become pregnant, based on age, overall health, and how much healthy tube remains. [1]
Your healthcare provider reviews several factors before recommending surgery:
Factor | Why it matters |
Your age | |
Overall health | Part of deciding whether surgery is an option for you |
How your tubes were tied | Affects whether the tubes can be repaired |
Length of healthy tube left | The surgeon needs enough tube to reconnect; more than 7 cm was linked to better results in one study [4] |
Other fertility issues | These can make pregnancy unlikely even with open tubes |
When can't a tubal ligation be reversed?
A tubal ligation can't be reversed when too much of the fallopian tube is gone or the end of the tube has been cut off. [1]
Reversal may also be impossible if the tubes were blocked with implant devices such as Essure® or Adiana®. These devices can cause permanent damage to the tubes. [1]
Your provider may also advise against surgery if other fertility problems make pregnancy unlikely. In that case, IVF is usually the alternative to discuss. [1]
What happens before tubal ligation reversal surgery?
Before tubal ligation reversal surgery, your provider explains the procedure and its risks and reviews your medical and pregnancy history, including details of your original tubal ligation. [1]
You may also need:
Blood tests
Imaging tests
A semen analysis for your partner or sperm donor, to check that sperm health isn't a barrier [1]
How is tubal ligation reversal surgery performed?
Tubal ligation reversal surgery is performed in a hospital under general anesthesia and takes about two to three hours. [1]
Surgeons use one of two main approaches:
Approach | How it's done |
Mini-laparotomy | One cut about 2 inches long, just below the bikini line |
Robotic-assisted laparoscopy | The surgeon controls robotic arms from a console, working through several tiny cuts in the abdomen |
Research shows the choice between modern approaches doesn't change pregnancy outcomes. [2]
Step by step, your surgeon will: [1]
Give you general anesthesia so you're fully asleep.
Place a catheter in your bladder to drain urine.
Make one or several small cuts to reach your fallopian tubes.
Check whether the tubes can be repaired. If they can, open the blocked ends and reconnect them.
Inject dye to confirm the tubes are open.
Close the cuts with dissolvable stitches and cover them with a bandage.
The six main steps of tubal ligation reversal surgery.
Is tubal ligation reversal painful?
Tubal ligation reversal is not painful during the operation because you're asleep under general anesthesia. [1]
Afterward, you may feel soreness around the incision. Your provider will prescribe pain medicine to keep you comfortable. [1]
What happens right after tubal ligation reversal?
Right after tubal ligation reversal, you stay in the hospital for monitoring until it's safe to go home. [1]
You may feel sleepy or groggy for several hours as the anesthesia wears off.
An adult must drive you home.
Your provider will explain how to care for yourself during recovery. [1]
What are the risks of tubal ligation reversal?
The risks of tubal ligation reversal are low. [1]
Possible complications include:
Infection
Bleeding or blood clots
Allergic reaction to anesthesia
Damage to nearby organs during surgery
The main pregnancy-related risk is a higher chance of ectopic pregnancy, where a pregnancy grows outside the uterus. The risk is still well below the chance of a normal pregnancy, but it is real. [1] A large review reported ectopic pregnancy in 4–8% of women after reversal. [2]
What is the success rate of tubal ligation reversal?
The success rate of tubal ligation reversal is between 5 and 8 out of every 10 women becoming pregnant. [1]
The range is wide because many factors affect results:
In one study of 93 women, pregnancy and delivery rates dropped clearly with age: [3]
Age at surgery | Positive pregnancy test | Term delivery |
27–35 | 95.7% | 73.9% |
36–39 | 77.5% | 47.5% |
40–42 | 68.4% | 52.6% |
43–47 | 36.4% | 27.3% |
Pregnancy and delivery rates after laparoscopic tubal reversal fall with age.
How long is recovery after tubal ligation reversal?
Recovery after tubal ligation reversal takes about four weeks in full, with most people back to normal activities within two weeks. [1]
Time after surgery | What happens |
Day of surgery | Monitoring in hospital, then home with an adult driver |
Within 2 weeks | Back to most normal activities |
About 4 weeks | Full recovery |
After 2 menstrual cycles | Safe to start trying to conceive |
A few months | An HSG (X-ray dye test) may check that the tubes are still open |
1–2 years | The window when most pregnancies happen |
Always follow your own provider's recovery instructions. [1]
A typical recovery and conception timeline after tubal ligation reversal.
How soon can you get pregnant after tubal ligation reversal?
You can start trying to get pregnant after tubal ligation reversal once you've had two menstrual cycles. [1]
Most pregnancies happen within the first one to two years after the surgery. [1]
Is IVF a better option than tubal ligation reversal?
IVF can be a better option than tubal ligation reversal for some people, depending on age and the condition of the fallopian tubes. [1]
Reversal may suit you if… | IVF may suit you if… |
Enough healthy tube remains | Too little tube remains, or the end was cut off [1] |
Your tubes weren't blocked with implant devices | Devices such as Essure® or Adiana® were used [1] |
You're younger | You're older; IVF may be more cost-effective at older ages [2] |
You have no other major fertility issues | Other fertility problems make reversal unlikely to work [1] |
There's no fixed age cutoff. Direct comparisons between reversal and IVF are limited, so the choice is a personal one made with your provider. [2] Learn more about assisted reproductive technology.
Does insurance cover tubal ligation reversal?
Many insurance plans don't cover tubal ligation reversal because it reverses an elective procedure. [1]
Ask your insurer about costs before you decide.
When should you call your healthcare provider after tubal ligation reversal?
You should call your healthcare provider as soon as you get a positive pregnancy test after tubal ligation reversal, so they can check for ectopic pregnancy. [1]
You'll also have a follow-up visit after surgery. Your provider will tell you which problems need a call before that visit. [1]
Conclusion
Tubal ligation reversal gives many people who had their tubes tied a real chance to conceive naturally. Success depends most on age, along with how much healthy tube remains and how the original ligation was done. Recovery is usually quick, and the main extra risk is a small rise in ectopic pregnancy. If reversal isn't possible or likely to work, IVF is the main alternative.
Thinking about having your tubes untied? Book a consultation with a fertility specialist to check whether you're a candidate, and explore our guides to IVF, female infertility, and ectopic pregnancy to prepare your questions.
FAQ
What is tubal ligation reversal?
Tubal ligation reversal is a surgery that reopens or reconnects the fallopian tubes after tubal ligation so you can try to get pregnant. It is also called tubal reanastomosis.
Can every tubal ligation be reversed?
Not every tubal ligation can be reversed. Reversal isn't possible if too much of the tube is gone, the end was cut off, or the tubes were blocked with devices such as Essure® or Adiana®.
What is the success rate of tubal ligation reversal?
Between 5 and 8 out of every 10 women become pregnant after tubal ligation reversal. Age is the biggest factor, with higher success in younger women.
How long does tubal ligation reversal surgery take?
Tubal ligation reversal surgery takes about two to three hours in a hospital. Most people go home the same day.
How long is recovery after tubal ligation reversal?
Most people return to normal activities within two weeks of tubal ligation reversal. Full recovery takes about four weeks.
How soon can I try to get pregnant after tubal ligation reversal?
You should wait two menstrual cycles after tubal ligation reversal before trying to conceive. Most pregnancies happen within the first one to two years.
Does tubal ligation reversal increase the risk of ectopic pregnancy?
Tubal ligation reversal increases the risk of ectopic pregnancy, which happens in about 4 to 8 in 100 women afterward. Call your provider as soon as you get a positive pregnancy test.
Is tubal ligation reversal covered by insurance?
Tubal ligation reversal is often not covered by insurance because it reverses an elective procedure. Check costs with your insurer before deciding.
Who is a good candidate for tubal ligation reversal?
Good candidates are usually younger, in good health and have enough healthy fallopian tube left to reconnect. Your provider also checks for other fertility issues before advising surgery.
What tests are done before tubal ligation reversal?
You may need blood tests and imaging, and your provider reviews records from your original tubal ligation. A semen analysis for your partner or sperm donor checks that sperm health is not a barrier.
Related Reading
Tubal Ligation: Procedure, Recovery, Risks, and Effectiveness explains how tubal ligation works, its recovery and its effectiveness.
In Vitro Fertilization (IVF): A Comprehensive Patient Guide walks through each step of IVF and who it may help.
Ectopic Pregnancy: Symptoms, Causes, and Treatment covers the warning signs of ectopic pregnancy and how it is treated.
Hysterosalpingogram (HSG): Timing, What to Expect and What It Finds describes the X-ray dye test that checks whether fallopian tubes are open.
References
Cleveland Clinic. Tubal Ligation Reversal: Procedure, Risks & Results. Cleveland Clinic. Last updated June 30, 2026. https://my.clevelandclinic.org/health/treatments/17584-tubal-ligation-reversal
van Seeters JAH, Chua SJ, Mol BWJ, et al. Tubal anastomosis after previous sterilization: a systematic review. Hum Reprod Update. 2017;23(3):358-370. PMID 28333337. https://doi.org/10.1093/humupd/dmx003
Godin PA, Syrios K, Rege G, et al. Laparoscopic Reversal of Tubal Sterilization; A Retrospective Study Over 135 Cases. Front Surg. 2019;5:79. PMID 30687715. https://doi.org/10.3389/fsurg.2018.00079
Feng Y, Zhao H, Xu H, et al. Analysis of pregnancy outcome after anastomosis of oviduct and its influencing factors. BMC Pregnancy Childbirth. 2019;19(1):393. PMID 31666022. https://doi.org/10.1186/s12884-019-2469-2
Medical disclaimer
This article is for general education only and does not replace advice, diagnosis, or treatment from a qualified healthcare professional. Always talk with your doctor about your own situation before making decisions about surgery or fertility treatment.
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