For several decades now, the Filshie clip method of sterilisation, commonly known as having the tubes clipped, has been the accepted gold standard. This is largely because the method is considered to be a pain-free and permanent barrier to unwanted pregnancies with very few, if any, side effects.

However, around 1 in 10 women regret having the procedure and start to wonder if a reversal is possible in order for them to become pregnant and have a baby.

There are potentially two routes back to fertility following sterilisation with Filshie clips; either In-Vitro-Fertilisation (IVF) or tubal reversal surgery. Which option is best for you depends on several factors that we will discuss below.

Tubal reversal surgery (reversal of sterilisation)

Sterilisation reversal surgery is usually a minimally invasive procedure and can be done laparoscopically (keyhole) or through a cut in the tummy. If it is keyhole, then this means that you will have 3 to 4 very small incisions (around 1cm in size) made in the abdomen through which a iny camera and other operative instruments are inserted, to locate the fallopian tubes and facilitate the removal of the Filshie clips and repair of the tubes. It takes 2-3 hours to complete the surgery as it is technically very difficult, because of this it is not always an option for everyone.

Having a tubal reversal the traditional ‘open’ way, with a small incision on your lower tummy (around where a c-section scar would be found), is a slightly bigger operation and takes 1-2 hours to complete. Because of the bigger incision you may require slightly more recovery time, but both have excellent pregnancy outcomes.

Both surgeries are carried out under general anaesthetic and all being well you should be able to go home the same day or the day after with painkillers. More information about the surgery can be found here. You can then start trying for a pregnancy 2-3 weeks later.

In Vitro Fertilisation

For some, the thought of undergoing a tubal reversal surgery can be daunting and a reason why we are often asked if this is the only option for a future pregnancy. For a woman who, for any reason, doesn’t want to go through a reversal of sterilisation, In Vitro Fertilisation (IVF) may offer the ideal solution.

IVF is a procedure in which eggs are collected directly from the ovaries, fertilised outside the body and then implanted into the womb, bypassing the fallopian tubes. It’s ability to bypass the tubes is the reason why IVF was originally invented! IVF is used to treat a range of fertility problems, and can carry a good success rate. However, IVF is not a quick fix, it can be a lengthy process from start to finish and its overall success rate per cycle of IVF is much lower than with reversal surgery.

IVF consists of several stages, starting with ovarian stimulation. Hormone injections are given to stimulate the ovaries into producing multiple follicles (which contain the eggs). Injections are self-administered at home every day (don’t worry if you are squeamish, as your partner can be taught to administer them!) over a period of nearly two weeks. In conjunction with the daily hormone injection, another type of medication is started mid way
through the injections, either as a nasal spray or an injection, to prevent the pre-collection release of eggs (premature ovulation).

You will be closely monitored throughout this process with regular ultrasound scans. These scans track the growth of these follicles in order to pick the best time for egg collection and optimize the number of healthy eggs collected. Just prior to harvesting the eggs, another hormone injection is administered (‘the trigger injection’) to encourage the eggs to mature and give them the best chance of successful fertilisation.

The egg retrieval process is done under sedation or local anaesthetic in an IVF unit. A fine needle is passed through the top of the vagina under ultrasound guidance into the ovaries. and the follicle fluid aspirated to collect the eggs. Despite all the scans and monitoring, it is impossible to predict exactly how many eggs will be collected. In rare cases (around 1 in 400), despite what is seen on the ultrasound scans, no eggs are collected. After around 5 days, the fertilized eggs (embryo(s)), can be transferred to the womb.

Not sure which option is right for you?

Any surgical or medical procedure carries with it complications, and success depends on various factors, all of which your surgeon will be only too happy to discuss with you to enable you to decide which is the best course of action for you to take.

It might be helpful to look at the success rates for a female reversal of sterilisation here at our Clinic. We have many years experience in helping women to become pregnant have the majority do. 

Mr Dobson who runs the clinic is also a specialist in IVF. You might consider having a consultation with him so that you can consider the best way forward for you. He can then advise you on your chance of success with either procedure to help you make the right decision for you.