Sterilisation is difficult and expensive to reverse so think twice before choosing this option, says Dr Gillian Lockwood
The decision to be sterilised is often, unfortunately, taken in haste and repented at leisure. Women may be unhappy with their method of contraception or have had a particularly difficult, disastrous or unplanned pregnancy.
Men may be certain that they will never want to father another child, or be anxious about failure rates with the Pill or condoms. But sterilisation must be regarded as an irrevocable decision and, in today's world where nearly 40 per cent of marriages end in divorce, couples must be aware that they may want to have more babies someday, somewhere else - and with someone else.
If you have been sterilised and now regret that decision, what are the options?
The vast majority of female sterilisation operations involve placing little clips or loops around the Fallopian tubes, which block the tube and prevent egg and sperm from meeting.
This procedure is done by laparoscopy - an operation that involves placing a fine telescope with a light on the end through a tiny cut in the abdomen (in the belly button). This allows the surgeon to inspect the pelvis - particularly the uterus, ovaries and Fallopian tubes. A laparoscopy is done as a day case in hospital and is performed under a general anaesthetic.
It is possible to reverse this operation by cutting out the damaged section of tube and joining the ends back together. However, this is a very complex operation, usually involving microsurgery (the Fallopian tubes are less than one millimetre in diameter).
Success rates vary from 20-80 per cent, depending on the skill of the surgeon, the age of the woman and the time since the sterilisation was performed.
If the original operation was a tubal ligation - in which the tubes were cut and 'tied off' or 'heat-sealed' with diathermy, success rates for reversal are lower. All women who get pregnant after reversal of sterilisation are at an increased risk of an ectopic pregnancy.
Getting around the problem
The alternative for women wanting to get pregnant after sterilisation is IVF, the 'test-tube baby' technique. In IVF, egg and sperm are mixed in little glass dishes so that fertilisation takes place. The resulting embryos are placed directly in the uterus, thereby by-passing the blocked tubes.