The chances of conceiving after having a tubal reversal are considerably better than with IVF, with a 70 to 80% safe success rate for those women who are under 40 years of age.  Most women are able to conceive naturally within a year of their surgery.

When does the ectopic rate after tubal reversal enter in critical risk zone?

There is no set age limit for the risk of an ectopic pregnancy after tubal reversal, but some empirical data suggests that women above 40 have a higher risk in general with tubal reversal, and likewise with ectopic pregnancy after a reanastomosis. The risk of an ectopic pregnancy among the general population is about 1 in 100 and this risk increases to about 5 in 100 after undergoing a tubal reversal.

There is some optimistic analysis of the fertility results observed as well. Although it was demonstrated that age is the most significant predictive factor, for women who had undergone a microsurgical tubal anastomosis procedure (tubal reversal) at age 40 years or older, the reproductive outcomes of the microsurgical tubal anastomosis patients demonstrated a tubal reversal was a justifiable alternative to IVF, even when considering an ectopic pregnancy rate of 2.4 percent.

Managing ectopic pregnancy after tubal reversal

It is important that women are aware about the risk of ectopic pregnancy prior the tubal reversal.  Early diagnosis is needed once a positive pregnancy test is obtained.  If the blood pregnancy test (HCG level) is 1,500 or greater, the contents of the uterus should be seen with a vaginal ultrasound exam. Early diagnosis at this stage is important.  If it is diagnosed that you have an ectopic pregnancy, one or two doses of a prescribed medicine will absorb the ectopic.  Note that time is most important thing, and there are limits to the use of medicine in treating ectopic pregnancy. If the ectopic pregnancy is too far along, the only option may be surgery, and in this case it is extremely important to have a skilled minimally invasive surgeon such as Dr. Morice perform the procedure so that when removing the ectopic pregnancy the fallopian tube suffers minimal damage.

What makes you fit for having a tubal reversal?

Patients need to be more aware of the fertile possibilities of tubal reversal before going for a tubal reversal.  The factors that go into whether a tubal reversal is right for you are:

1. Age:  Better if you are less than 40.  Analysis of the fertility results demonstrated that age was the most significant predictive factor.  This directly links to ovulation. Decide about a tubal reversal at the right time.  There is a sharp turn down in fertility that starts to occur approximately at the age of 36 in women.  Even so, the chances of pregnancy stay good until women reaches 40.  If a woman is beyond the age of 43, the chances of producing eggs in good health can be much lower.

1. Type of ligation: As there are many types and methods of performing bilateral tubal ligation (ie by rings, clips, fulguration, Parkland, Pomeroy, Falope ring, coagulation, and Irving), the damage to the tubes may differ from one patient to another. If the tubal ligation is performed without excessive damage to the tubes, nearly all types of tubal ligations can be reversed with a tubal reversal procedure. To ensure patency, after tubal reversal a colored dye is used to examine the patency of the fallopian tubes.

1. Blockage site on the tube.  HysteroSalpigoGram (HSG) is the test that allows Dr. Morice to better evaluate the blockage site on the tubes in the prospective patient for tubal reversal, and to get a better idea of how much proximal tubal length is available for a tubal reversal or reanastomosis.   If the ligation method caused excessive scar tissue on the blockage site, this could minimize the potential of fertility later.  The amount of healthy tube remaining is extremely important when considering a tubal reversal to regain fertility.

1. Hormone levels:  Checking the hormone levels is an excellent indicator of fertility and must be considered for all patients over the age of 30 before a tubal reversal.  This includes a day 2-4 FSH level and estradiol level.

1. Normal uterus: All patients undergoing a tubal reversal should have an ultrasound report prior to the procedure. Dr. Morice performs this as part of the routine work-up and this is included in the price of the tubal reversal procedure.

1. Some other factors:  There are other factors that provide good predictive value for success with tubal reversal. These include your general health, obstetrical history, partner’s health, social habits such as smoking and drinking, and frequency of intercourse.