Check-UP| Reversing the Tubal Ligation process
Reversing the Tubal Ligation process
Novelette, 36, who has two children, underwent tubal ligation five years ago. So much has happened since that she finds life so amazing. She lost her partner within months of the tubal ligation and has been involved with a new partner for the past two years. He doesn't have any children and she would love to give him one. She was told at the time of her "operation" that it is a permanent procedure, but she has also heard of it being reversed. She is considering visiting a "gynae" to have the process reversed but would like to hear more about the procedure. She has been told that it is costly, but is it likely to be successful?
Tubal Ligation (T/L) is considered to be a permanent surgical procedure which ties off the Fallopian tubes attached to the womb (uterus) to prevent female eggs from reaching male sperm coming up from the uterus to be fertilised. It is a very effective method of birth control but "life happens" and reversal may become necessary. Tubal ligation reversal is possible and can effectively restore fertility in many women. Successful pregnancy after reversal of a tubal ligation will depend on the following:
n Age of the female
n Site where the tubes were tied
• Other female gynaecological problems which may be present such as endometriosis or fibroids
• Ovulation function
• Experience of the surgeon performing the procedure
Most T/Ls are performed in the middle of the tube and this area must be excised and the remaining portions of the tube re-attached with small stitches. When T/L is done near where the tube joins the uterus or at the other end of the tube where it is larger and more delicate, chances for a successful reversal procedure are less. Sterilisation where the entire end of the tube is removed is not reversible at all.
However, if tubal ligation was performed mid-tube, as is most often the case, and if clips were used in the procedure which again is often the case, then the evidence is that the reversal procedure will have a very good chance of being successful.
In order to reverse the T/L the gynaecologist removes the "tied" section of the tubes and realigns the remaining healthy tube tissues to re-establish a complete tube. Recovery time following T/L reversal surgery is minimal. Pregnancy can be attempted after the second post-op period and chances of conceiving are, over all, satisfactory to good. An alternative to tubal ligation reversal is "in vitro fertilisation (IVF) and is recommended for women over 35.
Should I get the anti-tetanus shot during pregnancy?
Mikala, 36, is pregnant. She asks about the use of anti-tetanus shots during pregnancy. She last took a DT (Diphtheria and Tetanus) shot in her "teens" and has been asked by her doctor to take another shot at this time. She is worried that the shot can affect the developing baby. The use of DT immunisation in pregnancy is recommended as follows:
" The un-vaccinated pregnant woman should receive DT to stimulate the development of antibodies which will also cross over the placental barrier to help prevent both herself and her infant from developing lock jaw. This has been proven to decrease morbidity and mortality to both mother and infant.
" Booster injections are needed at the time of an injury or pregnancy if it has been over 5-10 years since the adult has received an anti-tetanus booster.
" Booster DT injections should be given every 10 years even if no injury has occurred to renew the antibodies in the body which protect against both Diphtheria and Tetanus which are dreadful illnesses and often fatal. There is no proof that this booster causes any harm.
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