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Tubal Reversal vs. IVF?

dr. jason bromer of shady grove fertility
Medical Contribution by Jason Bromer, M.D.

Many women who have had a tubal ligation, commonly referred to as “having your tubes tied,” find themselves wanting another child due to life changes. But can a woman get pregnant if she’s had a procedure that is considered a permanent form of birth control? Yes, and talking to a reproductive endocrinologist is the first step in determining all of the options.

Dr. Jason Bromer, of SGF’s Frederick and Hagerstown, MD offices, says, “Women with tubal ligations are some of our most successful patients because we know that they have been fertile before. There are two ways pregnancy can be achieved after tubal ligation. Traditionally, the only option for patients was through a surgery called a tubal reversal. However, there is now another option for women with in vitro fertilization, or IVF.”

In almost every case, IVF is the better option because it gives patients the highest chance of pregnancy in the shortest amount of time and avoids a significant surgical procedure.

Tubal Reversal Surgery

Tubal ligation can be performed in a number of different ways, but the result is always the same – an interruption of the Fallopian tubes that prevents pregnancy. “The most common method of tubal ligation is the surgical removal of the middle section of the tubes,” says Dr. Bromer. “So, the goal in a tubal reversal surgery is to reconnect the tubes to make them open all the way through.”

The latest methods for performing a tubal reversal surgery require only 1 day for the procedure and 7 days of light bed rest following it. About 3 months after the surgery, patients have a hysterosalpingogram (HSG) to check the status of the tubes. An HSG is a diagnostic test using x-ray technology to show the flow of dye through the uterus and Fallopian tubes into the uterine cavity. It shows if there are any blockages remaining in the tubes that might prevent pregnancy.

Tubal Reversal Success and Increased Risks

Whether or not tubal reversal surgery can be successfully performed depends on two factors. “Is there enough healthy tissue on each end of the tube to be reconnected,” explains Dr. Bromer, “and is the reconnected tube long enough to function properly? Unfortunately, not all patients have tubes that can be reconnected.”

“Sometimes even when reattaching the tubes is successful, there can be scarring of the tissue that interrupts the flow of the tube,” says Dr. Bromer. “This happens in about 20 percent of the cases.” If, however, the HSG confirms that the tubes are open, then the patient can begin trying to get pregnant on her next cycle.

There is also an increased risk for ectopic pregnancy after tubal reversal surgery. “One risk with tubal reversals is that there is a 10 to 20 percent chance of having an ectopic pregnancy after tubal reversal surgery,” says Dr. Bromer. Ectopic pregnancy occurs when a fertilized egg gets stuck in the Fallopian tubes and implants there. Ectopic pregnancies must be terminated with medications or surgery to avoid a rupture of the Fallopian tube, which can be life threatening.

Since the tubes cannot always be reconnected, the success rate for achieving pregnancy after a tubal reversal is around 40 percent for women under 37.

IVF and Success Rates

Another popular option for women trying to get pregnant after a tubal ligation is in vitro fertilization or IVF. IVF is a process by which an egg is fertilized in the lab and then transferred to a woman’s uterus. This allows for pregnancy to occur by completely bypassing the Fallopian tubes.

Any woman who has a good ovarian reserve or has previously attempted a tubal reversal unsuccessfully would be a good candidate for IVF treatment. Dr. Bromer adds, “Even couples with fertility challenges other than the tubal ligation, such as advanced age or male factor infertility, can be helped by IVF.”

An IVF cycle takes about 2 months to complete. After the evaluation and hormone suppression phase of the cycle, patients are prescribed injectable hormones that stimulate egg maturation. During this 10 to 12-day stimulation period, the patient is seen frequently for ultrasound and bloodwork to monitor the growth of egg containing follicles and the levels of hormones.

At the end of this period, an egg retrieval procedure is performed. The eggs are fertilized with the partner or a donor’s sperm and grown to 3- or 5-day embryos. Then, one or more embryos are transferred to the woman’s uterus. Two weeks later, a blood pregnancy test reveals the results.

The success rate for achieving pregnancy with IVF frequently exceeds that of a tubal ligation. At SGF, IVF has a 50 to 60 percent success rate for women under 38, even when only one embryo is transferred.

View Shady Grove Fertility’s IVF Success Rates

Four Things to Consider:

1. Time to Pregnancy 

It takes about 3 months after a tubal reversal surgery to confirm that the surgery was a success. Once the tubes are shown to be clear by the HSG test, the average time to pregnancy, from start to finish, is 2 years.

“The fact that it can take up to 2 years to become pregnant after tubal reversal surgery is really off-putting to a lot of my patients,” says Dr. Bromer. “Most of them are anxious to get pregnant sooner, often because they are older when they start the process.”

“One of the best things about IVF is that the time to pregnancy is so much shorter,” says Dr. Bromer. A cycle of IVF takes only about 2 months to complete. Some women require multiple rounds of IVF to achieve pregnancy, but even with difficult cases, treatment is usually completed within 1 year.

2. Age

Age is a key factor in the decision between IVF and tubal reversal surgery. As a woman ages, the number and quality of her eggs decline, making it harder to get pregnant. As early as 30 years old, a woman’s chances of getting pregnant each month start to go down.

Since many women who want to get pregnant after tubal ligation are in their 30s, there is a chance that even with a successful tubal reversal surgery, they won’t become pregnant, as the 2-year time to achieve pregnancy becomes even more significant. In this case, it is likely that IVF would be recommended. To avoid having to do surgery and IVF, it is recommended that these women choose IVF as the first line of treatment.

“For women over 37, I would almost never recommend tubal reversal surgery,” says Dr. Bromer. “In this age group, where declining fertility is coupled with a higher risk of ectopic pregnancy, IVF is clearly a safer option with better chances of success.”

3. Cost

Tubal reversal surgery and one cycle of IVF cost about the same amount, ranging between $10,000 to $15,000. Tubal reversal surgery is almost never covered by insurance.

SGF has several innovative financial programs that reduce the cost and financial risk associated with treatment. These include the Shared Risk 100% Refund Program, Multi-Cycle Discount Program, Shared Help Discount Program and options for grants and loans for fertility treatment.

The most popular is SGF’s Shared Risk 100% Refund Program. This plan entitles the patient to up to six rounds of IVF and the related frozen embryo cycles. If the patient does not take a baby home, 100% of the fee is refunded.

“With the Shared Risk program and the success rates being so high at SGF,” says Dr. Bromer, “IVF is almost always the more cost-effective option.”

4. Male Partner’s Fertility

One more factor that can tip the scales is the male side of the equation. Having a sperm analysis completed for the male partner is a critical step in making the decision about whether to use IVF or tubal reversal surgery. “If the male partner of the couple has a low sperm count for example,” explains Dr. Bromer, “then even a successful tubal reversal surgery is not likely to result in pregnancy.”

IVF, however, can be performed with special techniques that work around the male factor issues. Intracytoplasmic sperm injection (ICSI), for example, is a process in which a single healthy sperm is injected into the center of each egg resulting in normal rates of fertilization even in men with severely abnormal sperm counts.

The Prognosis is Good

Dr. Bromer says the key to this decision is a thorough evaluation and a discussion of the patient’s goals. “I suggest that couples come in and bring all the paperwork about their tubal ligation surgery,” he says. “We will do some basic fertility testing on both partners and go from there – but the first step is making an appointment.”

For some women, the answer will be tubal reversal surgery. “The ideal candidate for tubal reversal surgery is a woman under 35, who wants multiple additional children and who had a well-performed tubal ligation,” Dr. Bromer says.

“The majority of my patients, however, have had multiple children, but now have a new partner, and want to have only one more child with their new partner. For these women, IVF is nearly always a much better option.”

“Either way, the prognosis is good. With a little expert guidance, women with tubal ligations can be back to changing diapers in no time,” adds Bromer.

Editors Note: This post has been updated for accuracy and comprehensiveness as of January 2021.


To schedule a virtual consultation with an SGF physician, please call our New Patient Center at 1-888-761-1967 or submit this brief form.


  1. Bridgett Knapp

    November 24, 2019 - 9:55 am

    I am 37 had my tubes tied 9 yrs ago I am wanting a baby by my now boyfriend is it possible and will my insurance pay any the cost.

  2. Kea C

    September 29, 2019 - 6:39 pm

    I had my tubes removed in 2017. I am now 30 yrs old, with 2 kids & would like to extend my family. Would it be better to do ivf or get the reversal surgery. I really want another child & I want the best option possible

  3. harleyquinn

    July 29, 2019 - 12:01 am

    My husband had a testicular torsion years ago and I had a tubal ligation. We want to have a kid together but are not sure what the best way to go about it is. due to these constraints is a reversal the best of option or IVF?

    • Shady Grove Fertility

      July 30, 2019 - 6:23 pm

      Hi Lisa,

      If you and husband have already had these procedures done then I would recommend making an initial consultation with a fertility specialist so that you can get a more precise response to your question. IVF is the solution for many women who have had tubal ligation, however it’s important to talk to a physician about what treatment plan will work for you based on your medical history. If you don’t already have a specialist I would advise you to make an appointment with SGF by either filling out this brief form or calling our New Patient Center at 1-877-971-7755

      Wishing you the best of luck!

  4. Ferris Erskine

    May 27, 2019 - 4:14 am

    I am 37 and had a tubal ligation 9 years ago, my boyfriend has no children. I would like to know more about IVF and what the risks are? What age is too old to try to get started?

    • Shady Grove Fertility

      July 18, 2019 - 5:29 pm

      Hi Ferris,

      Great questions! We have a lot of information on our website about IVF success rates and the risks involved with any treatment. Because you had a tubal ligation, IVF would likely be the best treatment option so we recommend making an appointment with one of our fertility specialists in DC, MD, PA, VA, GA, or FL by calling 1-877-971-7755 or by filling out this form. A physician would be able to discuss with you how age impacts treatment and what your next steps might look like.

      Wishing you the best of luck in your #ttcjourney!

  5. Emily Nice

    May 23, 2019 - 11:52 am

    25 with 3 kids , 7 , 5 and 4 … tubes tied , 5 year old son has DIPG brain cancer with only months to live . i want another baby in 2 years . how do i start ?

    • Shady Grove Fertility

      July 18, 2019 - 6:01 pm

      Hi Emily,

      So very sorry for your son’s diagnosis, we’re keeping you in our thoughts. As for getting started, you have a couple of options to choose from. If you’re not quite ready to make an appointment with a fertility specialist, we recommend reading our SGF Blog to become informed of your treatment options given your tubal ligation procedure, and also attending our free, online education events. Since IVF is a common option for women like you who have also gotten their tubes tied, you may be interested in registering for our IVF Webinar next week, where you’ll have the opportunity to ask questions to one of our physicians at the end of the program.

      Or, if you’re ready to make an appointment, you can call 1-877-971-7755 or fill out this form.

      Wishing you the best of luck!


    May 6, 2019 - 2:47 pm

    Hello I am 29 years old I got my tubes tied after I had my last son my son’s father passed away when I was six months pregnant with him I made A bad decision to get my tubes tied because I didn’t want anymore kids now that I am remarried my husband now has no kids and we would love to have another baby but we come from a poor family and are on a fixed income is there anyway that we qualify for the IVF and he is fixing to be 49 this year. You don’t know how much this would mean to us both. Thanks.

    • Shady Grove Fertility

      July 19, 2019 - 6:18 pm

      Hi Metallica,

      First, so sorry to hear about your #ttc journey and I admire your passion to want to continue building your family. With IVF treatment, we offer a Shared Risk 100% Refund Program which essentially ensures you against the risk of not being successful. We only earn our payment when you take home a baby, so you will pay a flat amount that covers the medical cost of up to six cycles of IVF treatment. To find out if you and your husband qualify for this program, you’ll have to make an appointment at one of our locations in MD, VA, PA, FL, GA, or NY by calling 1-877-971-7755 or by filling out this form.

      We know that costs can be intimidating, but we try to make treatment accessible for everyone through our Shared Risk program and through insurance coverage.

      Wishing you and your husband nothing but the best in your #ttcjourney!


    May 6, 2019 - 2:39 pm

    Hi I would love to be able to have another baby I made a rash decision after my husband passed away to get my tubes tied after my last son my husband now does not have any children and it would be very nice to have another kid I am fixing to be 29 years old would I qualify for the IVF but I also come from a very poor family and on a fixed income

  8. Ann Gonzales

    May 6, 2019 - 6:52 am

    Hi I’m Ann I’m 40 and have 9 kids I had my tubes tied in 2011 with my twins.. me and my husband not the father of my other kids want one more baby he is 34 and has no kids would I be a good candidate

  9. Jessica

    March 28, 2019 - 6:58 pm

    Does insurance ever cover if you have your tubes tied?

  10. Annie Crowley

    January 4, 2019 - 5:51 am

    I am 46 my tubes are tied I have 3 children my youngest is 12. My Boyfriend and I want a baby. Am I to old for IVF?

    • Shady Grove Fertility

      January 8, 2019 - 5:49 pm

      Hi Annie, the best way to find out is to come in and meet with a reproductive endocrinologist and get your fertility tested. They will help you find the best course of action based on your results.

  11. Kimberly Boehm

    September 8, 2018 - 7:51 pm

    So I’m 36. I have 3 children. My oldest is 20, she is in the army, and I have 2 boys 17,& 13. I really miss having a baby around. I’m wondering what I have to do to qualify for the Ivf? Me and my boyfriend have been together for 12 years and we really want a baby. We come from poor family’s. Anyway I was just wondering what the chances are for a couple who doesn’t have much but has lots of love for children. Thanks

    • Shady Grove Fertility

      September 24, 2018 - 4:04 pm

      Hi Kim, your age still makes you a candidate for ivf. We accept many insurances and have different financial programs. If you would like to learn more, please call 1-888-761-1967.

  12. Mary

    August 16, 2018 - 3:48 pm

    I have been married for 14 years. I have two children and had my tubes removed in 2008. I am now wanting another child, but my husband is not 100% on board yet. Can this process be started without him?

    • Shady Grove Fertility

      September 24, 2018 - 4:31 pm

      Hi Mary, you can start the process of consulting with physicians on what your treatment plan would be, but you husband would have to consent to his sperm or donor sperm to be used later on down the road. If you have any other questions or are looking for more information on tubal reversal, please call 1-888-761-1967.

  13. Shaleena

    August 3, 2018 - 4:50 pm

    Hi my name is shaleena I and 25 almost 26. My girlfriend and I would like to have a child but my tubes have been tied for a year, what steps can I Take to getting pregnant?

    • Shady Grove Fertility

      August 6, 2018 - 1:36 pm

      Hi Shaleena, we offer different treatment options for you and your girlfriend to start a family. Read more about them here or call 1-888-761-1967 for more information about our different LGBTQ treatment options.

    • Melanie Ioramo

      October 18, 2018 - 11:40 am

      Hi! My name is Melanie, I am 40 years old, I have 5 children. My eldest daughter is 21 and my youngest is 12 years old. I had my first 2 given birth naturally and my other 3 kids c-section.When I had my 3rd c-section I also had my tubes tied,that was back in 2006. But I remarried and my husband and I really want a baby of our own.Is there any chance at all for us?

      • Shady Grove Fertility

        October 24, 2018 - 3:31 pm

        Hi Melanie,
        You are still able to get pregnant with fertility treatment. If you would like to learn more about how, please call 1-888-761-1967.

  14. Jerry

    July 9, 2018 - 9:18 pm

    I have had a vasectomy and my fiance has tubes tied from prior marriages. We want a baby together is it possible

    • Shady Grove Fertility

      August 3, 2018 - 8:28 pm

      Hi Jerry, this is possible with many different factors that would decide your best treatment option. Call 1-888-761-1967 for more information.

  15. tomas wilson

    July 2, 2018 - 7:39 am

    mmh true

  16. Tyiesha Mitchell

    June 29, 2018 - 12:51 am

    Hello my name is Tyiesha, I’m 40 I have 4 children. Me and my husband want another child. But I’ve had my tubes tied for 16 years. Is it possible for me to have a reversal after so long?

    • Shady Grove Fertility

      June 29, 2018 - 2:00 pm

      Hi Tyiesha, it is possible, but there is no guarantee that you will be able to conceive after the procedure. I would recommend speaking to one of our specialists, they will offer the best medical advice for your situation. For more information please feel free to call 888-761-1967.

  17. Anita Williams

    March 22, 2018 - 1:21 am

    My tubes are tied and want to have another. I wanna know how much it cost it have an IVF done

    • Shady Grove Fertility

      March 30, 2018 - 7:14 pm

      Hi Anita, please call our new patient center at 888-761-1967 to schedule a consult.

  18. Jayme Kelley

    January 13, 2018 - 4:38 pm

    My fianceé has two boys and a girl, and I have two boys and a girl, but I had a tibal ligation after I had my youngest child. I finally found a man that treats me like a princess, doesnt cheat, doesnt lie, has a good job that hes had for years, and he treats my children well, which has been a recurring problem over the course of trying to have relationships since my two sons were born. I know that we both trust each other enough to consider having another baby, as we have both already seen how each other act with the children in a relationship that was terminated: his kids mothers have kept his kids from him out of spite, and my kids fathers have done the same to me, but neither of us have ever done this to them, and I feel like it would be safe to have a baby with him. But we are torn, as we have six children total already, and the procedures listed above are expensive. Although I am sure my fiancee would say the cost is of no consequence, I worry that it is too much money, and that I may never become pregnant again. I wish I could do this.

  19. Daria

    December 7, 2017 - 9:21 pm

    I’m 43. Downs Syndrome is a real risk at my age. Is there genetic testing of the embryos done prior to transfer?

  20. anesha johnson

    July 30, 2017 - 5:31 pm

    Well I’m 34 and I have 4 kids with my husband but we have boys and we want a girl… My oldest is a girl but is from a previous relationship. I wanted to do a tubal but just saw that ivf would be a better route. Any thoughts or suggestions I am also type 2

  21. Shelley Lombrano

    June 16, 2017 - 4:42 am

    Thinking of a boy strongly after tubal ligation but over 41 and hubs is 49 with two older. We have two girls 2 &. 5

  22. Joanna

    May 22, 2017 - 2:47 am

    I am 40 I have 3 kids An had my tubes tied now remarried to a wonderful man who is a great father to my 3 kids An he has no children of his own an I would love to add just one more given him the greatest gift what is the cost of I’ve

  23. zodwa

    April 25, 2017 - 9:09 am

    I want another baby but my tube are tied please help

  24. Jessica

    March 27, 2017 - 2:01 am

    Ivf how much is it?

  25. Crystal Wells

    October 26, 2016 - 8:46 am

    I am in a relationship with a man I plan to marry. He has no children to my six.. I love him and would love to give him a child of his very own. Most concerned about price.

    • Brenda

      February 9, 2017 - 5:58 am

      Check to see if your insurance would cover it mine did even after having insurance we still paid $2000 out of pocket to meet my insurance out of pocket exspense on top of the $15,000 My insurance covered it’s very expensive especially if you don’t have insurance… it is well worth it and I’m glad I done it & don’t have to worry about getting pregnant again after I deliver,Great experience and worth every dime to be able to share a child with someone you love.

      • Mary

        April 2, 2017 - 9:27 pm

        Where did you get it done?

      • Victoria

        April 6, 2017 - 3:18 am

        What type of insurance did you have that paid? I’m 37/38 and my dr. Tied my tubes right before a twin c-section surrogacy. She didn’t believe in it and within minutes of the surgery she had me sign this paper and I woke with a tubal ligation.

      • Tamara

        March 12, 2018 - 12:00 am

        What insurance did u have

  26. Crystal Kuechenmeister

    September 12, 2016 - 1:59 am

    I am on my second marriage have had a tubal ligation almost 11 years ago, I am in my mid 30’s and wondering which option would be best for me!

  27. Ashley Morgam

    August 17, 2016 - 8:41 am

    The costs of getting tubal ligation reversed with the help of this surgery range between $5000 to $8000 I guess. It is good that we are learning the benefits of the tubal reversal surgery and additionally, the success rate is also encouraging. I still remember, at one stage doctors only used to suggest IVF as the only option.

  28. chenelle jemison

    June 27, 2016 - 9:19 pm

    Wanted to know how much it cost to have this surger. I had my tubes tied in 2004 and now I want another child. It cost so much to get my tubes untied

  29. Alejandra Helmer

    March 2, 2016 - 7:47 am

    I had my tubes cut 2 inches after having my 4 child. After 14 years of marriage I’m divorce and have someone new in my life he treats my children like his own. But would love to have another child reverse tubal is to much for me but ivf I was wondering if that would work for us and how much it would cost.

    • Angela sakapaji

      August 10, 2019 - 12:59 am

      my tubes we’re cut 13 years ago after having my fourth child ,I’m a divorcee now I’m in a new relationship my boyfriend wants a baby is it possible to do insemation

      • Shady Grove Fertility

        August 12, 2019 - 1:48 pm

        Hi Angela!

        Many women have found success with different treatments after a tubal ligation procedure, but without knowing your medical history I can’t say for sure which one would be best. If you’re interested in speaking with a physician, I’d recommend making an initial consult with a fertility specialist to learn what options are best for you, and then going from there. A specialist will be able to review your history and offer a personalized plan to help you and your boyfriend get pregnant. SGF has locations in MD, VA, PA, GA, Fl, and NY, so if you’re looking to make an appointment then call 888-761-1967 or fill out this form :)

        Best of luck!

  30. Keya Jackson

    January 22, 2016 - 1:05 am

    Four years ago my husband and I had our third daughter by CSection and subsequently had my tubes tied. We would now like to consider IVF to add a baby boy to our family. I am 38 and my husband is 41.

    • lucy

      February 5, 2016 - 5:39 pm

      I would love to have a baby boy now two but im 40 and my husband is 34 and he is asking me to have a baby for about 2 years now

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