Many women (and even their physicians) think that IVF is the only real option for a pregnancy following a tubal ligation. Yet in reality, tubal ligation reversal is a real option and in many cases a better choice for most women. Tubal  ligation reversal offers a higher success rate and comes at considerably lower cost.

A study of over 5000 women undergoing tubal revealed some important findings if you are considering a tubal ligation reversal. In the study only 36% of the women undergoing IVF achieved successful pregnancy and even fewer, about 30% of the women in the study, carried the pregnancy to completion and had a baby. In comparison, women who chose tubal reversal became pregnant 66% of the time! Additionally, for women over 40, who often have a more difficult time getting pregnant the results were even more surprising: only 1 in 6 women who chose IVF had a successful pregnancy in contrast to the 1 in 3 women who had a baby following tubal reversal, double the chance with IVF! For younger women under the age of 30 years old, 43% of women who had IVF delivered a baby while more than half (55%) of their peers choosing tubal reversal became moms. These numbers prove that tubal reversal is effective and a better choice over in vitro fertilization.

In addition to being more successful in the study, tubal ligation reversal is less expensive, involving a one time payment at the time of surgery after which a woman can try for pregnancy as many times as she wishes. In comparison to IVF, where the costs can be quite staggering and you are required to pay for each cycle of treatment – regardless of whether or not you get pregnant. In fact, sometimes women will pay for repeated cycles of IVF month after month, without ever getting pregnant at all!

Of course, don’t just take our word for it. If you’ve had a tubal ligation and are thinking about becoming pregnant, be sure to check the pregnancy statistics and success rates for tubal reversal versus IVF for yourself. We’re convinced that after looking into it you’ll be convinced for that a tubal reversal is a cheaper, more effective and flexible procedure for your pregnancy!

In many cases women wanting to have children again after tubal ligation think that  IVF or in vitro fertilization is their only option. Often they simply haven’t heard of tubal ligation reversal and are unaware that it not only increases their chances of conceiving but also is significantly less expensive than IVF. During a tubal ligation reversal the separated segments of the fallopian tube are rejoined, restoring the pathway for the egg to the uterus so that it can be fertilized naturally by sperm. Typically the procedure takes about anhour, a little longer than the initial tubal ligation, an with a slightly extened recovery time because of larger incision and more time spent in surgery. Still, in most cases the procedure can be done with minimal invasiveness. To reduce the recovery time and to simplify the surgery, experts have developed new surgical techniques including making small incisions and using cameras to guide the surgery to ensure the effectiveness laparoscopically. Not all hospitals and surgeons use this approach, so be sure to ask if it’s available in your area.  Dr. Morice performs tubal ligation reversal using both techniques, but since a small, open incision is much less expensive, most couples choose to have an open procedure rather than a laparoscopic procedure.

Though inexpensive and minimally invasive in most cases, a tubal ligation reversal is not appropriate for every woman. There are some specifics you’ll want to be sure to discuss with your doctor to find out if tubal ligation reversal surgery is right for you.

Tubal length:

If your fallopian tubes have been significantly shortened the procedure may be more difficult and less effective. In the initial surgery the tube is separated in the middle, leaving one end connecting near the ovary, the other to the uterus. The longer the two tubes are, the easier it will be to reattach them and the more likely the operation will be successful. Unfortunately, it is not always possible to verify the length of the two ends before tubal ligation reversal surgery.

Sperm quality:

In some cases infertility can result from problems with male sperm quality. For those couples, IVF is a better option.

Age:

When a woman gets older, surgery and pregnancy becomes more complicated. If you’re over 38 and considering pregnancy and a tubal ligation reversal it is important to discuss your health and your options with your physician to make the decision that’s best for you and your family.

Ovarian quality:

As women age, the number of eggs they have decreases. This can be checked before tubal ligation reversal surgery so that Dr. Morice can let you know if your ovarian reserve is large enough to make a pregnancy possible.

Some of the easiest ways to begin saving extra money are by opening a separate savings account and depositing a portion of your paycheck into it every month. Other things to consider include cutting back on unplanned spending at coffee shops or convenience stores, as well as looking for other budget controlling methods on the web. For instance cutting back on your cable bill can help you save between $50 and $100 a month. Some times individuals have considered looking for a part time second job to help save up for the cost of the tubal ligation reversal.

Another option to consider is using your family’s income tax refund to pay for the tubal  ligation reversal surgery. A lot of times people don’t count on having this money available. Planning on setting this money aside to help cover the cost of your procedure goes along way to making your dream of having another child a reality.

In most cases insurance companies do not cover  the costs of surgery as part of their plan. If your insurer offers to pay for some or all of the procedure make sure to have it in writing. That way when it comes time to pay for the procedure all your bases are covered! Alternatively, if you have a fl

Even after having a surgical sterilization by tubal ligation, it is still possible to have more children. Typically this begins with a tubal ligation reversal where patients have their tubes “untied”. Thankfully, tubal ligation reversal can be done with a minimally invasive surgery and a tubal reversal has a high rate of success. If you’re thinking about having a tubal ligation reversal, chances are, you have some questions.

First and foremost you’ll want to know about your chances of getting pregnant after a tubal ligation reversal. For family planning, you must understand how maternal health and age contribute to the likelihood of conceiving and delivering a child regardless of the situation. For women under 35 years of age in good health, the rates of conception and delivery are very high. Tubal ligation reversal success rates start to decline after women are older than 37, strictly due to the fact that the rate of pregnancy declines as you get older. Still, even women over 40 years of age have a great chance of getting pregnant in the first year after tubal reversal, up to 80% depending on the other factors involved for the individual patient.

The type of tubal ligation performed has an impact on the success rate of a tubal ligation reversal. The tubal reversal procedure is most successful if your doctor used Filshee clips or Rings for the sterilization, as these leave the most healthy tube that can be put back together during the tubal ligation reversal. In contrast, if the tubes have been clipped or shortened, the success rate may be slightly lower because they cause greater damage to the tubes and results in a shorter tube after the tubal ligation reversal.

Other important factors to consider are other aspects of your general and reproductive health. For instance, if you have a history of endometriosis, intrauterine fibroids, or low egg count, you may have a decrease the likelihood of conceiving and successfully carrying a pregnancy to term. Your partner’s health and sperm count will also play a role in your fertility. Consequently it may be important to see a doctor and have a full fertility analysis prior to having a tubal ligation reversal.

Although tubal ligation reversal can allow many women to conceive, the reversal does not guarantee pregnancy. Unfortunately, women who have undergone ligation and then tubal ligation reversal have slightly higher rates of ectopic pregnancy.

It is important for every woman to discuss this and the other risks and benefits of the tubal ligation reversal with their doctor to understand how it will impact their health. In some cases, even otherwise healthy women can have difficulty becoming pregnant. In those instances it may be necessary to consider IVF of in vitro fertilization.

Overall, the success rate of a tubal ligation reversal can be as high as 80%, much higher and more successful than In Vitro Fertilization.

It is a woman’s prerogative to change her mind. Consequently, some individuals find themselves considering tubal ligation reversal. With high success rates and few complications, tubal ligation reversal surgery is an attractive answer for women and couples considering parenthood.

During the procedure, a surgeon restores the path from the ovary to the uterus that had been previously cut or “tied” during a tubal ligation procedure as a way to prevent pregnancy. Tubal reversal repairs the  tubes thereby allowing natural pregnancy to occur when the egg and sperm come together following intercourse.

In some individuals the procedure leads to immediate success and pregnancy, while in others conception takes some time. For all women who choose tubal ligation reversal, taking time to understand their cycles and when they ovulate is useful. This can be accomplished by checking your daily temperatures and using an ovulation predictor test to discover when you are most fertile.

The number of couples succeeding in getting pregnant after tubal ligation reversal is quite high., up to 80%. Often it happens so quickly that it can be surprising to a couple that was not actively trying to conceive, rather just thinking about having  that option available some time in the future. Many couples attribute this to the lack of anxiety they had about the process. Though not scientifically proven, this explanation is true enough for the couples that experience pregnancy. The success rates are so high following tubal reversal that many couples have more than one pregnancy following the procedure. The 2009 Tubal Reversal Pregnancy Report supports this procedure with statistics proving the effectiveness of the surgery, showing how it has paved way for many women and their partner’s interested in achieving natural pregnancy.

Tubal ligation reversal is considerably less expensive than invasive in vitro fertilization (IVF) and is available to patients from around the world.

Post Tubal Ligation Syndrome occurs in women who have undergone tubal ligation and endometrial ablation (a minor surgical procedure for abnormal bleeding where the uterine lining is destroyed rather than undergoing a complete surgical removal of the uterus).  Approximately 6 months to 1 year following their ablation procedure or tubal ligation women may experience cyclic pelvic pain.  The pain can be on one or both sides and can be severe.

The symptoms of PTLS (Post Tubal Ligation Syndrome) are the following:

• Hot flashes
• Night sweats
• Flushing
• Chills
• Headache
• Racing pulse
• Dizziness
• Difficulty concentrating
• Irritability
• Anxiety
• Depression
• Mood swings
• Nausea
• Bloating
• Weight gain
• Change in hair growth pattern and thinning fingernails
• Fatigue
• Difficulty sleeping
• Decreased libido
• Breast tenderness
• Decrease in breast size
• Painful intercourse
• Irregular heavy or light bleeding
• Osteoporosis
• Uterine prolapsed, where the uterus becomes misplaced through the vagina

Although it is not entirely clear what causes PTLS, it is correlated with a previous history of tubal ligation.  Some studies have indicated that women who undergo tubal ligation may be at risk factor for hot flashes, chills, night sweats, and other menopause-like symptoms.  These changes are thought to be related to changes in estrogen and other hormone production in the ovaries.  These changes can lead to loss of normal monthly ovulatory cycles as a result of the change in ovarian hormone production that is thought to occur as a result of tubal sterilization and endometrial ablation.

Depending on a patient’s particular situation, tubal ligation reversal surgery has been considered as a method to reduce the pelvic pain symptoms many women experience after a tubal ligation.  For some women, the desire to return to a more normal pattern of menstrual cycles may be reason to consider a tubal reversal.  The ligation reversal gives the woman back not only the option to consider pregnancy in the future but also can help relieve the symptoms associated with Post Tubal Ligation Syndrome.

Although in most cases ovarian cysts are nothing to be concerned about, occasionally they can cause pain, and in rare instances they can be cancerous.  Non cancerous cysts occur as a result of normal process or a minor abnormality that can clear up on its own.  In those circumstances Dr. Morice may recommend that you follow up in a month or two to see if the cyst has resolved on its own.  In certain circumstances Dr. Morice might recommend further imaging, medications,  or even surgery to better understand what is causing the cyst.

Because there are many different types of cysts, Dr. Morice may want to get a better understanding of what is causing yours, particularly if you are undergoing a tubal ligation reversal.  Identification can be done with an ultrasound before the tubal reversal is performed just to make sure that there isn’t anything more concerning occurring prior to your surgery.

The 5 most common types of ovarian cysts are:

-          Functional cysts

-          Endometrial cysts

-          Cystadenomas

-          Dermoid cysts

-          Polycystic ovaries

Functional cysts are the most common among young women who are cycling normally, regardless of wether they have had a tubal ligation reversal. These cysts are a normal process of menstruation and usually clear up on their own without you or Dr. Morice ever even knowing about them. There are 2 types of functional ovarian cysts. The first comes from the Graafian follicle (or sac) where the egg develops every month. It is the most common and occurs if the sac fails to break open and release its egg.  The second type of functional cyst is a simple fluid filled cyst.  Both types typically resolve on their own in one to three months.

Another remnant from the monthly cycle is a corpus luteum cyst. After the egg is released, this portion of the ovary usually disintegrates. However, if the woman becomes pregnant, for example after a tubal ligation reversal, sometimes this cyst can form if the sac seals off. This ‘sealing’ of the cyst wall results in a buildup of fluid.  Again these cysts normally resolve in a few weeks with most women remaining unaware that they’re even there. The likelihood of getting an ovarian cyst is not increased at all by a tubal reversal.

Occasionally the cysts can become enlarged and rupture. This may cause a little bit of bleeding and pain. Sometimes the blood will collect inside of the cyst itself, and this is called a hemorrhagic cyst. Although a hemorrhagic cyst can be quite painful, it is also a benign condition that can be safely watched without intervention and without concern for an underlying cancer.  As always, if you have concerns about pelvic pain or your risk for ovarian cancer you should discuss these concerns with Dr. Morice.

What is meant by a positive Quad Screen?

A positive test means having a high risk of chromosomal abnormalities or neural tube defects. The Quad Screen can be implicated as an early precursor with an extensive deal of ensuing scientific improvements to deal the underlying problems. Patients with a positive screening are then further recommenced for more insightful and specific procedures. Most tubal reversal patients will elect to undergo invasive procedures such as an amniocentesis.

Sensitivity adjustments of the Quad Screen:

Although 78% sensitivity and 5% false-positive rate of the test makes it widely available in most countries as a common option to classify risk, the estimated sensitivity of the risk is calculated and attuned on certain factors including:

o the expectant mother’s age

o diabetic condition of the mother

o twins or other multiple gestation

o the gestational age

o weight of the mother

o ethnicity may also be adjusted in markers

These factors influence the markers, and thus interpretation is indicated for the increased risk.

Integrated Screening

This involves combined first-trimester nuchal translucency and PAPP –A, plus second-trimester Quad Screening, and improves sensitivity to 90%. As most tubal reversal pregnancies occur in older patients, many will opt for the Integrated Screen.

Limitations of the Quad Screen:

1. The test is not for a definite diagnosis

2. The test is only a precursor for more predictive amniocentesis.

3. The age of the mother is indicative for amniocentesis.

Possible Risks of a Tubal Ligation

The possibility of tubal ligation failure has the greatest risk for ectopic pregnancy. It is debatable and questionable that Post Tubal Ligation Syndrome consists of only a few medical symptoms or that it is possibly a direct side effect and/or another risk of tubal ligation. In most studies, those who do have symptoms after having a tubal ligation consider these symptoms Post Tubal Ligation Syndrome.

What is considered the major cause of these symptoms?

Several of the symptoms of PTLS (Post Tubal Ligation Syndrome) are linked with having estrogen or progesterone imbalance. There are many research and case studies leading to controversies about these hormone imbalances. It is assumed that imbalance may be the direct result of capillary damage and decreased blood supply to the ovaries during the surgery. The damage to the veins and capillaries is quite varied and slight damage may possibly result in a slight estrogen progesterone imbalance.

For a woman who has both of her ovaries still functioning, if blood supply was not damaged to the uterus and ovaries, then she may experience PTLS due to estrogen/progesterone imbalance by some change in her hormonal message relay system.

Hormonal message relay system destruction is questionable

The assumption behind this is destruction of “target” or “receptor” cells that are significant in the relay of hormonal messages for the female reproductive system. It is unspecified that these cells might be injured, damaged, and or detached during the tubal ligation surgery. Having assumed that these target or receptor cells are positioned within the fallopian tube, many people consider a tubal ligation to be the cause of the destruction of some of these cells. For patients who believe this hypothesis, a tubal reversal would not be an option to reverse symptoms of PTLS. Tubal reversal should only be performed for patients who therefore have a strong belief that the symptoms are related to blockage of their fallopian tubes.

A chromosomal abnormality like Down syndrome is associated with advancing maternal age.  A number of diagnostic tests are currently available which may detect Down syndrome during pregnancy.  These include the nuchal translucency ultrasound and Quad marker screening, among others.

What is a Nuchal Translucency Ultrasound?

A nuchal translucency ultrasound is a sonographic prenatal test which can identify a high risk pregnancy during the first trimester.  It is performed between the 11th and 14th  week of gestation.  Aside from Down syndrome, the test can also detect an increased risk for major heart efects and other chromosomal anomalies in the fetus. Because it is performed during the first trimester, compared to the Quad marker test performed during the second trimester, parents are able to know their risk much earlier in the pregnancy.

The test however does not provide a final diagnosis.  If a mother is in the high risk category, she is often advised to undergo an amniocentesis or a chorionic villus sampling.  These procedures are invasive and entail a small risk for miscarriage.  Findings from these two procedures will generally give the parents a definite diagnosis.

How is the Nuchal Translucency Ultrasound performed?

Nuchal translucency ultrasound is performed either by placing an ultrasound probe over the lower abdomen or by gently inserting a thin ultrasound probe into the vagina.  Ultrasound will measure the thickness of the fold located at the back of the fetal neck. Other information needed during the test includes the age of the mother, the gestational age of the fetus, and additional bloodwork.

What are the factors that influence the test results?

The following are important factors that influence the findings from the nuchal translucency ultrasound:

- Age of gestation (should be between the 11th and 14th week

- The scan is obtained with the fetus in the sagittal position

- Hyperflexed or extended position of the fetus may affect results

- The fetal image is enlarged to 75 percent within the screen

- The nuchal lucency should be distinguished from the underlying amniotic membrane

Is a history of tubal ligation reversal a risk factor for a chromosomal disorder?

Tubal ligation reversal has absolutely no adverse affect on the fetus. The correlation between a tubal reversal and any chromosomal disorder is strictly due to the fact that most patients who undergo a tubal reversal are older, and that older patients are inherently at increased risk for a chromosomal disorder in the fetus.