Background. Tubal reconstruction after previous tubal sterilization remains an important fertility-restoring procedure for women wishing to conceive naturally. In Lithuania, voluntary tubal sterilization for contraceptive purposes is not legally permitted, whereas in countries such as the United States, Canada, the United Kingdom, Australia, and most Western European states, voluntary tubal sterilization is legally accessible and widely practiced. Purpose. To review, based on recent scientific literature, the possibilities of tubal reconstruction after prior sterilization by evaluating the clinical outcomes of reanastomosis, comparing them with assisted reproductive technologies, and discussing relevant surgical techniques, selection criteria, and technological innovations. Materials and methods. A descriptive literature review was conducted using PubMed and Google Scholar databases with the following keywords and combinations: “tubal reanastomosis”, “In vitro fertilization and tubal ligation”, “robotic surgery”, “barbed sutures”, and “tubal sterilization complications”. 23 sources published between 2015–2025 were included in the analysis. Results. Tubal reanastomosis was found to be an effective fertility restoration method in carefully selected patients, especially women younger than 35–37 years with ≥4–6 cm of remaining tubal length. Reported pregnancy rates reach 42–69%, with most conceptions occurring within 6–12 months postoperatively. In younger patients, clinical pregnancy rates of 60–75% and live-birth rates of 50–55% are commonly achieved. Reanastomosis is more cost-effective for younger women planning more than one pregnancy; however, the risk of ectopic pregnancy and postoperative adhesions remains elevated. Assisted reproduction is generally more effective for women over 40 years of age. Conclusions. Tubal reanastomosis is an effective but selection-dependent fertility restoration method that remains an important alternative to assisted reproductive technologies.
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