In a small percentage of cases sterilization is regretted and reversal is requested. Microsurgical techniques developed and refined over the past 20 years have made reversibility possible with live birth rates of 30%-85%. In Canada the incidence of tubal ligation declined by 27.6% while the rate of vasectomy increased by 39.1% from 1976 to 1986 and by 1988 the rates of both procedures were equal. This trend has been attributed to the economic and surgical drawbacks of tubal ligation as its real cost is 3.5-4 times higher than that of vasectomy. Psychological studies have shown that regret is most likely to occur in women sterilized at the time of cesarean section or in the immediate post-partum period; in women who are under 30 years of age; and in women who have experienced marital difficulties or emotional problems in the year prior to the ligation. Factors that affect the pregnancy rate following tubal ligation reversal include: the length of the remaining fallopian tube the type of sterilization performed the site of sterilization and the availability of both tubes for reconstruction. Pregnancy rates appear to be optimal if the reversal is done less than 5 years after the ligation. Gynecologists have changed from the more mutilating procedures to the more reversible ones because of the impact of sterilization on its reversibility and the uncertainty of many patients. A study found that 64% of women who presented for a reversal balked when the sterilization record was reviewed; and only 76% of women who were offered surgery proceeded with the operation. The establishment of in vitro fertilization (IVF) and embryo transfer as a legitimate clinical treatment of tubal infertility challenges the validity of surgery for the woman with a tubal ligation. The newly emerging art of sperm microinjection combined with the IVF technique is also promising when reversal is contraindicated. With the advent of reliable egg cryopreservation the reversal of sterilization will by unnecessary.