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A woman considering a tubal reversal must first determine if she is eligible for the procedure. In some cases, the initial sterilization may have prevented any hope of reversal. For example, a sterilization technique known as fimbriectomy involves removal of the end of the fallopian tube. This type of sterilization generally cannot be reversed. In addition, reversal may be difficult if sterilization was achieved through cauterization (using electric heat). This type of sterilization may damage more of the fallopian tubes, resulting in a greater difficulty with reconnection.

To determine a woman’s eligibility for the procedure, the physician will obtain a medical history of the patient and perform a physical examination. The physician will review information from the original tubal ligation procedure to gain insights into the likelihood of a successful reversal. The physician will also determine from blood tests if the woman’s hormone levels are adequate for egg production from the ovaries.

Patients can request a copy of the operative report from the physician who performed the surgery, or from the medical records department at the facility where the procedure took place. If segments of the fallopian tubes were removed during surgery, it might be helpful for the patient to request a pathology report that records the lengths of the tubal segments that were removed.

Tests are typically ordered to assess the state of the fallopian tubes before performing the procedure.  Physicians generally believe that at least 1 inch of healthy tube must remain if tube reconnection is to be successful. Tests used to examine the fallopian tubes include:

• Hysterosalpingogram. An x-ray that assesses the state of the fallopian tubes. In this procedure, dye is injected into the uterus. If the fallopian tubes are open, the dye will fill the tubes before spilling into the abdominal cavity. This can help the physician determine whether the tubes are blocked.
  
  
• Laparoscopy. A procedure that uses a long, slender tube with a camera on the end called a laparoscope. The laparoscope is inserted into the abdomen through an incision so the fallopian tubes can be examined.   

Candidates for tubal reversal must not have any other health conditions that may prevent pregnancy, including age-related factors such as menopause. The method used for the original sterilization and the presence of any scar tissue in the pelvis also may be factors that prevent a woman from having a successful tubal reversal. Finally, the woman’s partner will have his sperm count tested to ensure that he is physically capable of fathering a child.

If a woman is approved for tubal reversal surgery, the procedure should be scheduled during the week following her period. She should follow all of the preparatory recommendations made by her physician. These may include not eating or drinking anything after midnight on the day of the surgery. In addition, patients may be asked to briefly alter their medication routine.