Refertilisation

Sterilisation is a method of permanent contraception for women who have completed their family planning. The term sterilisation is understood to mean the surgical production of permanent infertility.

In most cases, the procedure is performed with a laparoscopy. In this procedure, both fallopian tubes are electrically coagulated at two adjacent sites. Alternatively, the fallopian tube function can be interrupted by clips or plastic rings. Regardless of the method, sperm and egg cells can no longer meet. Fertilisation and pregnancy are therefore impossible.

Treatment options

If, contrary to original considerations, there is still a desire to have a child at a later date, two treatment options come into question.

In addition to in vitro fertilisation - fertilisation of eggs outside the body - (see IVF for more information), the fallopian tubes can be surgically reopened. This so-called refertilisation only makes sense if the sperm count is normal and the menstrual cycle is normal with regular menstruation and detectable ovulation. Refertilisation is not recommended for women > 40 years of age, as the age-related probability of pregnancy is already relatively low.

Refertilisation surgery

In the first step of the operation, the blocked fallopian tube sections are dissected and removed. Then a catheter is inserted into the fallopian tubes via the uterine cavity. The respective ends can now be reunited via this splint. This is done with a 2-layer single-head suture with very thin threads. Without touching the mucous membrane of the fallopian tubes, first the inner muscle layer is adapted and sutured and then the outer so-called serosa layer. This completes the anastomosis. Afterwards, the success of the operation is checked by rinsing the fallopian tubes with dye and the instruments are removed.

Chances of success with surgery

The surgical restoration of tubal patency takes about 1.5-2 hours. The operation is generally not covered by the health insurance funds. Patients recover after only one week off work and can then become pregnant immediately. The success of the operation depends not only on the age of the woman but also to a large extent on the extent to which the fallopian tubes have been destroyed by the sterilisation. At least 3-4 cm of remaining fallopian tubes should be preserved. We prefer to use minimally invasive laparoscopy to restore the patency of the fallopian tubes (reanastomosis). The success rate of refertilisation is 50-60%.

Which centres offer refertilisation?

Not all fertility centres offer women the option of reversing sterilisation. At our centre in Berlin, our experts with many years of experience will assist you with refertilisation.