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Reversal of Sterilization or IVF: Q&A with Dr. Ton


18 May 2025
Updates

Reversal of sterilization or IVF: Which is better?

Many people may not know that nowadays, besides reversing sterilization, IVF is another option for those who have been sterilized to have children without needing to reverse the sterilization. Professor Poonsak Suchanwanich shared an interview about which method is better between sterilization reversal and IVF, including their pros and cons.

Dr. Ton explained that sterilization is always considered permanent, with no option to choose whether it’s reversible or not. Regardless of the method, sterilization is permanent.

How is sterilization done for women and men?

Female sterilization:
The fallopian tubes on both sides are cut and tied off to separate the parts as much as possible, preventing the egg and sperm from meeting. Besides cutting, sometimes electrical cauterization is used to destroy cells and blood vessels in the area to prevent reconnection.

Male sterilization:
The vas deferens (sperm ducts) are cut, preventing sperm produced in the testicles from flowing out during ejaculation. This is called vasectomy.

Is reversing sterilization a good option if you want children?

We must understand that the fallopian tubes are not just passageways for sperm and egg to meet but also have many small glands inside that produce nutrients to nourish the embryo. After fertilization at the tube’s end, the embryo grows from a single cell to 2, 4, 8, then 16 cells, doubling continuously. As the embryo develops, it travels to implant in the uterus, relying on nutrients from the fallopian tube.

Therefore, if a portion of the tube is cut, and later you want to reconnect it, the tube’s length is reduced. The nutrient-producing area is lost, so the chance of natural pregnancy after reversal is very low.

What are the consequences after sterilization reversal?

For women:
The embryo lacks nutrients to develop. Even if the tubes are successfully reconnected and usable, the shortened tubes damage the embryo’s growth environment, making pregnancy unlikely.

For men:
After vas deferens reconnection, the tubes shorten, and the testicles are pulled closer to the body. Testicles produce sperm best at cooler temperatures, which is why they hang outside the body. If pulled closer inside, the temperature rises (~37°C), and sperm production decreases or stops.

Summary

he doctor advises not to reverse sterilization. The best option is to do IVF instead. IVF solves the problem of embryo quality because you can be sure the embryos have no nutrient deficiencies. Thus, IVF avoids the pain and difficulty of sterilization reversal.

Sterilization reversal for women is challenging, requiring expert surgeons and operating under a microscope due to the small area. Even after reconnection, there is a chance of blockage.

Therefore, if given the choice, IVF is recommended.

Thanks to Professor Poonsak Suchanwanich for the information.

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