Tubal Reversal FAQ
- Can my tubes be reversed?
- What type of surgeon does these procedures?
- What tests do I need before a Tubal Reversal?
- Are the fees affordable for the Tubal Reversal Surgery?
- What is the risk of multiples?
- What is the risk of tubal pregnancy?
- What about having more than one child?
- Ethical Dilemmas?
- How successful is it?
- How do I schedule an appointment for a Tubal Reversal?
- How long is the procedure?
- How big is the incision?
- How soon can I go back after my surgery?
- When do I need to see my doctor after the surgery?
- What risks may be associated with Tubal Reversal?
- How soon can I attempt pregnancy after the surgery?
- How long does it take to get pregnant?
Can my tubes be reversed?
This is the most important question but depends on many different factors. If you are >40 years of age, it is strongly recommended that you consider IVF rather than a tubal reversal. Please consult with your SRM MD to discuss the evaluation needed and your chances for success for your particular medical situation. To make an appointment, please call 206-301-5000 or apply online.
The vast majority of women with prior sterilization can have their tubes re-opened. It is important that you obtain a copy of your surgical operative report and pathology report. The operative report will describe the type of tubal ligation that was done and the pathology report (if available) may give an estimate of the length of tube that was removed. These reports will be reviewed by an SRM physician if you are able to bring them to the initial consultation.
Weight is also a major negative factor in pregnancy success with any fertility therapy but is especially important when surgery is considered. High weight can increase surgical difficulty, increase anesthesia risk, require a longer incision, increase intra operative length and complicate and prolong postoperative recovery. Based on body-mass-index (BMI) (a ratio of weight versus height), the following recommendations are guidelines:
- BMI >40 strongly suggest against any elective fertility therapy until weight is reduced. This must strongly be considered against your age as losing weight may take time, time you may not have based on your age. Consult with your SRM physician.
- BMI 30-40 Loss of weight strongly suggested but fertility therapy not absolutely contraindicated. Reduction in pregnancy success with any fertility therapy expected.
- BMI <30 fertility therapy is fine.
What type of surgeon does these procedures?
Obstetrician-gynecologists with subspecialty fellowship training in reproductive endocrinology and infertility and microsurgery are most qualified. Technical skill levels of microsurgeons are based upon level of training and experience.
Our SRM physicians have all done an OB/GYN residency and specialty fellowship. As a result, they are doubled board-certified in Reproductive Endocrinology and Infertility (REI) and OB/GYN. They have received valuable additional training during their fellowships as microsurgeons and are fully capable of performing the micro tubal reanastomosis that will optimize your chances of conception. Not all REI's have this additional training.
topWhat tests do I need before a tubal reversal?
To assess the prognosis of success of a tubal reversal, it is recommended but not required to perform the following tests. To discuss the rationale of each of these tests in detail, please call 206-301-5000 or online to make an appointment.
- It is recommended that a semen analysis be performed on your current partner within the past year.
- A hysterosalpingogram, a dye test for your fallopian tubes to assess where the blockage is on the fallopian tube, may be recommended. Location of the blockage dictates successful pregnancy no matter how good the surgical technique to repair the tube is. Location of the blockage varies is based on how the original tubal ligation was done. The hysterosalpingogram is performed in our office.
- Hormone tests are recommended to assess your future fertility potential. These are called a day 2-4 FSH and estradiol and are also performed in our office. This is called ovarian reserve assessment. Click here for more details. (link to our ovarian reserve assessment PDF pt info)
- A transvaginal ultrasound to make sure your uterus is normal and your ovaries are "fertile" appearing and can be performed during your initial consultation.
- A hematocrit or complete blood count (CBC) is required prior to surgery to make sure you are not anemic.
Are the fees affordable for the tubal reversal surgery?
We have attempted to reduce the costs to you the patients as much as possible. The surgeon's fee, the anesthesia fee and the surgery facility fee have been "packaged" for your convenience so that there are no hidden costs when the pre-surgical evaluation is complete and you and your partner have decided to proceed.
The preoperative evaluation as described above is a worthwhile investment in determining whether or not to proceed with surgery. After all, before being subjected to the risk of surgery and anesthesia, patients should know their prognosis. There are many good surgeons but the very best surgeons are those that know when NOT to operate.
To find out, call to make an appointment with an SRM physician at 206-301-5000 or online.
topWhat is the risk of multiples?
There is no increased risk of having a multiple pregnancy following successful tubal reversal surgery. The risk of twins following IVF is approximately 30% and that of triplets is < 5%.
topWhat is the risk of a tubal pregnancy?
There is a 5-10% risk of a tubal pregnancy following tubal reversal surgery and a <1% risk following IVF.
topWhat about having more than one child?
Following successful tubal reversal surgery, a woman can have additional children at no additional expense. Following successful IVF, additional children will require additional IVF cycles. If there are frozen embryos left over from an IVF cycle, these frozen embryos can be used and significantly reduce the cost of a cycle.
topEthical dilemmas?
With a tubal reversal, natural conception occurs; therefore, no dilemmas can occur. For some couples, not all couples, of course, ethical dilemmas regarding the status and eventual disposition of the embryos can arise as a result of IVF. Our fertility counselors are readily available to you if you wish to discuss these issues. Please call 206-301-5000 or apply online to make an appointment. Learn more about our counseling programs.
topHow successful is it?
In the best prognosis patients, pregnancy occurs in 80% of our patient after 2 years of follow-up.
Pregnancy rates vary depending upon the type of tubal ligation, the age of the woman, and other possible fertility factors. This success rate depends on many factors based on the recommended workup prescribed by your SRM physician.
topHow do I schedule an appointment for a tubal reversal?
It's easy. Call 206-301-5000 to schedule an appointment with Dr. Paul Lin or Dr. Angela Thyer. You may also apply online.
topHow long is the procedure?
The tubal reversal procedure takes 2-3 hours to perform and 7-10 days for FULL recovery.
topHow big is the incision?
The incision is approximately a 6-10 inches just above the pubic hairline. We use suture to close the skin, which is reabsorbed by the body over six to eight weeks. This can be longer if you are overweight.
topHow soon can I go back to work after my surgery?
This depends on what you do for a living. In general, most patients who have jobs which are sedentary and do not involve heavy lifting, can return to work in seven to ten days. If you have a more rigorous job, ask your doctor what is appropriate for your situation.
topWhen do I need to see my doctor after the surgery?
You should arrange a post-op visit approximately two weeks after the surgery to make sure you are recovering as expected, the findings can be discussed and future treatment plan can be finalized. Certainly, if you have any problems prior to that visit, you should call your doctor or nurse.
topWhat risks may be associated with tubal reversal?
The RARE risks associated with the surgery may include injury to the bowel, bladder or blood vessels. There is the possibility of infection or anesthesia complications.
The major risk associated with tubal reversal is a tubal pregnancy which occurs in approximately 5-10% of pregnancies after microtubal reanastomosis surgery. When detected early, a tubal pregnancy may be treated medically and avoid the need for additional surgery.
When a patient becomes pregnant, it is important to contact us to perform serial blood pregnancy tests and an early ultrasound examination to determine the location of the pregnancy. Our staff will always be available to assist you if you have questions following your surgery.
topHow soon can I attempt pregnancy after the surgery?
You can attempt to become pregnant 2-3 MONTHS after tubal reversal surgery. This allows the tubes to properly heal.
topHow long does it take to get pregnant?
topIt depends. After 6-12 months, if not pregnant, we recommend a repeat hysterosalpingogram (dye that is injected through the uterus into the fallopian tubes) to confirm that the tubes healed open. If open which is likely, it could take up to two years after the surgery.
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