Our objective was to assess the clinical outcome of tubal reversal in women of advanced reproductive age.A multicenter retrospective chart review of 153 patients who underwent a tubal ligation reversal was carried out. Patients were evaluated according to age. All patients had documented ovulation and a partner with a normal semen analysis by WHO criteria. Outcome measures included rates of clinical pregnancy, ectopic pregnancy, spontaneous abortion, and live birth, and the time to conception.Clinical pregnancy rates were significantly lower in women > or = 40 compared to younger groups. The time to conception was significantly shorter for women or = 35. No pregnancies occurred in women > or = 42.Our data support the judicious use of sterilization reversal for infertile women with no male factor through their early forties. Women > or = 42 years should be especially counseled as to the very low success rates.