There is a relatively high success rates following tubal re-connection (reanastomosisis) in cases of previous tubal ligation (a birth rate of +/- 50% within 3 years of a successful surgery). However, IVF performed in a center of excellence produces almost the same success rate following a single attempt and is far less invasive than surgery. IVF also does not require general anesthesia, hospitalization, or a protracted time off work. Moreover by doing IVF and leaving the tubal ligation undisturbed, the woman retains subsequent control over family planning without having to resort to using some other form of contraception. Another point to be considered is the high incidence of tubal or ectopic pregnancy following the performance of tubal reanastomosisis high (about 20%).Major surgery also requires a few days of hospitalization and subsequently a few weeks of convalescence. There is also a risk of post-operative complications, increased cost, and time away from work, incapacitation, and significantly greater discomfort. The cost of a full cycle of IVF is in fact comparable to that of tubal reanastamosisis.
In my opinion, provided that IVF is performed in a program with high success rates, tubal surgery for fixing damaged or blocked Fallopian tubes, with few exceptions, can no longer be justified financially or ethically.