An alternative to tubal reversal center” href=”http://www.mybabydoc.com/”>tubal reversal is in-vitro fertilization (IVF).

Which method is better for regaining fertility?

Whether or not IVF or tubal reversal is better must be based on individual factors and workup.

IVF is a nonconventional method and involves the daily administration of fertility injections.  The patient’s response is checked over a 2-4 week period, together with frequent visits for further management.  At the appropriate time, the eggs are harvested from the woman by placing a needle through the vagina and into the ovary.  This procedure drains follicular fluid from the ovaries.  On the day of egg salvage, the husband’s sperm is combined with the patient’s eggs and the embryos are produced.  The succession of the fertilized eggs (now an embryo) is monitored over a phase of several days.  The embryos are transferred back into the patient’s uterine cavity by insertion of a small tube through the cervix and into the uterus.

Some reasons making IVF a less desirable choice than Tubal Reversal include:

• In general, one to four embryos are transferred, depending on the patient’s age.  The success rate of pregnancy is quite variable and may lead to multiple attempts. When couples are unproductive, they must want the process again, which is costly
• IVF has a much greater risk for multiple gestations than Tubal Reversal
• Some couples may not have the time nor wish to make multiple visits to the clinic, which are obligatory for IVF, and nt for Tubal Reversal
• Many of the steps for IVF are uncomfortable. Many people must convince themselves that the procedure may work ‘this time,’ unlike Tubal Reversal which involves just one procedure
• Risks of over-stimulating the ovaries are much greater than for Tubal Reversal, and can be very serious (Ovarian Hyperstimulation Syndrome – OHSS).

Tubal reversal is preferable for people who want to conceive naturally with a conventional procedure.

What are the disadvantages of having a Tubal Reversal rather than IVF?

• Tubal Reversal allows the possibility to conceive more pregnancies. This is a disadvantage for those who just want to have single child . This requires future contraception.
• Any pregnancy after Tubal Reversal needs to be monitored early due to an increased risk for ectopic pregnancy

Success rate comparison between IVF and Tubal Reversal:

• It is found 20-35% success rate via IVF.
• It is found 66% pregnancy rate over time via tubal reversal.

IVF is the best option for patients for whom tubal reversal is not possible, or in patients who are poor candidates for a tubal reversal. Many patients will have additional infertility factors presence, such as diminished ovarian reserve (can be evidenced by a rising follicle stimulating hormone (FSH) value), blocked fallopian tubes, advanced age, other medical conditions, or severe sperm abnormalities that make tubal reversal a less optimal procedure that IVF. Additionally, some tubal ligations remove too much of the fallopian tube to reanastomosis, and therefore a tubal reversal is less likely to be successful.

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.

Although we started with tubal ligation, we will proceed with this health education in a systematic fashion. The reason we wrote about tubal ligation before anything else is because we received most of the queries pertaining to tubal reversal, the symptoms and other associated areas.

We have decided to cover the vast area of menopause in various educatory sessions in a similar manner and hope to satisfy the curiosity of our loyal readership.

Comprehending Menopause

More than anything else, women need to learn about menopause in a much more detailed way than ever before. Even their male counterparts need to know about this so that they will understand what it is that women must endure.

Menopause is mandatory. Whether you like it or not, it is going to happen. It is nature’s way of relieving the women of their childbearing labor and giving them official rest. You can choose to enjoy this phase of your reproductive life, or worry endlessly because of countless unanswered questions.

Rather than avoiding discussing it, menopause should be embraced with an open heart and mind.

Clinical view of Menopause:

The verbatim definition for a layman:

Menopause is “the permanent cessation of menstruation, occurring usually between the ages of 45 and 55”.

A clinical definition of menopause which you all should know is:

Menopause is one day- the date when 12 months have gone by since your last period.

When you hear people around you, saying that X or Y is going through menopause, what they are actually referring to is perimenopause. Perimenopause is truly the span of transitional years around the last period ever, both before and after. Perimenopause can be understood in 2 phases.

1. Pre-Menopause
2. Post-Menopause

Together, they can be referred to as perimenopause or as the general public sticks to saying, menopause.

Around what age is usually perimenopause and menopause expected?

Where majority of the women undergo perimenopause between 45-55 years of age, variants have been noticed. We have seen as young as 34 and as old as 64 to undergo perimenopause, however such cases are rare.

When explaining about a medical condition such as menopause or perimenopause, we usually stick to the normal age range of the state, and hence in this case we will talk of the 45-55 years bracket.

Exactly how do I know I am in the brackets of Perimenopause?

If you are above 40 years of age, are experiencing a marked difference in your usual menstruation pattern and are having the trademark “hot flashes” and night sweats, it is highly probable that you have entered the perimenopause.

Do not account mood swings for the diagnosis since they alone are a highly undependable factor and have a multifactorial origin.

Is there any way I can delay it?

Menopause is nothing to be ashamed of, or to be delayed. It is as natural a change as menarche, the onset of menstruation. You only need to take care of yourself and your body. This change is important since as you grow older, your body loses the kind of power and energy required for carrying a pregnancy as well as a laborious child birth.

You may hear all sorts of false suggestions to delay menopause, like hysterectomy, tubal ligation, tubal reversal, or hormonal therapy, but this is inevitable and should be anticipated and prepared for, instead of against.

Embrace it instead of fearing it.

Tubal Reversal and MTR are the same. MTR stands for Microsurgical Tubal Reanastomosis. For many reasons (ie lifestyle and financial problems), women make the decision that they do not want to have any more babies. They decide to proceed with a tubal ligation. But there are many factors that occur later in life whereby women want to undergo a tubal reversal (MTR) to reverse this process. After tubal ligation, many women face problems such as irregular, heavy, or painful periods, anxiety, vaginal dryness, hot flashes, trouble sleeping, and even mood swings. While all of these symptoms cannot be attributed directly to the tubal ligation, a tubal reversal can help alleviate some of the psychological issues that may play a role in these symptoms.

Tubal Reversal (MTR) is a safe and effective surgery. It is been in practice for the last 30 years with very successful results. It is a very delicate operation so the doctor should be experienced enough to perform these delicate moves with microsurgical instruments and techniques. To reattach the two fine ends of the fallopian tubes, multilayer, microsurgical techniques are used. After the surgery is performed, a dye is injected through the fallopian tubes to get a confirmation that the fallopian tubes are now opened. Tubal reversal is a very sensitive procedure to be performed because all the delicate and precise moves of the surgeon during the surgery. The success and failure of a tubal reversal procedure is very dependent on these moves as well.

Dr. Morice and his team provide the excellent surgical care that maximizes the chances of a successful tubal reversal. Dr. Morice is an experienced expert in performing tubal reversal surgery with Microsurgical Tubal Reanastomosis (MTR) techniques.

After tubal reversal surgery, you will become very eager to start planning your pregnancy. You will dream of holding your cute new baby in your arms. You will start planning to welcome the new member of the family. This is very natural.

After tubal reversal, there are some points to keep in mind. When women get the good news that they are pregnant, they must take good care of themselves, and even some extra care as compared to the normal pregnancy. They must also track their cycle carefully as the chance of a tubal pregnancy or a miscarriage can occur. An early appointment with their physician is very important for tubal reversal patients.

After tubal reversal, if pregnancy is not achieved after a few months, don’t get too upset or worried. In the practical study of patients, pregnancy can occur on average from 6 months to a year. These results are related to the fertility of both parents.

After tubal reversal, some patients are interested in making sure that the reversal has not healed incorrectly and that their tubes are still open. A HysteroSalpingoGram (HSG) is a good method of evaluating the success of a tubal reversal. HSG should be done by an experienced doctor.

Dr. Morice and his team provide the excellent surgical care that maximizes the chances of a successful tubal reversal. Dr. Morice is an experienced expert in performing tubal reversal surgery with Microsurgical Tubal Reanastomosis (MTR) techniques.

Tubal reversal is the process of reattaching the fallopian tubes that were separated in the tubal ligation process. It is now completely possible to reverse this procedure for those couples who change their mind and decide that they want to have more children. The advancements made in tubal reversal surgery are very good news for those who wanted to have babies again after a tubal ligation.

In tubal ligation, doctors may clip, burn, tie, or cut the fallopian tubes. To adequately counsel the patient and her partner, we must have the detailed previous report of the tubal ligation surgery. Depending on the type of tubal ligation, we can access how many places the tubes are burned, or how much of the fallopian tube was destroyed. If these details are not mentioned, the tubal reversal success rate will not be as accurately determined prior to the surgery. In order to reattach the tubes, there must be some healthy part of fallopian tube for the tubal reversal. The total length of a fallopian tube is normally about 10cm. At least 5 cm of healthy tube on each side is optimal to conceive again with success rate of as high as 80%. Although pregnancies do occasionally occur with tubal lengths as little as 3 cm.

In the burning procedure of a tubal ligation, the normal practice of doctors is burning of three points of 1 cm each on both fallopian tubes. The process can also be performed with burning of tubes from two points. The success rate of a tubal reversal is directly related to the final length of healthy fallopian tube left after the tubal reversal.

Dr. Morice and his team provide the excellent surgical care that maximizes the chances of a successful tubal reversal. Dr. Morice is an experienced expert in performing tubal reversal surgery with Microsurgical Tubal Reanastomosis (MTR) techniques.

After tubal reversal, patients are discharged home within the same day of surgery. Tubal reversal surgery is an outpatient procedure. After tubal reversal, patients may experience some bleeding from the vagina due to the tubal reversal procedure. Patients may also have minor abdominal swelling and feel shoulder pain, backache, or muscular pain. Patients can take showers after 24 hours after tubal reversal, and baths one week after tubal reversal.

Most patients are also able to return to work one week after tubal reversal surgery. Patients can have intercourse two weeks after tubal reversal surgery, and then return to all other activities.

Tubal Ligation reversal is done through a microsurgical technique. This is the reason that tubal reversal surgery is also known as microsurgical tubal reanastomosis. For the tubal reversal surgery procedure, doctors will first test the patient and perhaps the partner to make sure that the tubal reversal will not be performed on a women who might otherwise be infertile. These tests will help determine if the woman is a good candidate for a tubal reversal. The woman must be both physically and emotionally prepared for tubal reversal surgery as well.

Doctors also advise patients to take pre-natal vitamins, engage in as exercise regimen, and to stop smoking before tubal reversal surgery. This not only prepares patient and her partner physically, but also emotionally. Having tubal reversal surgery and a new pregnancy and baby is both very demanding and challenging.

Before discussing about ligation reversal we will discuss about Tubal ligation. Tubal ligation permanently blocks the fallopian tube through which women are able to conceive a baby. Tubal ligation is generally regarded as a permanent solution to prevent a pregnancy. When most women decide to have a tubal ligation, they are completely certain that they will not want more children for the rest of their life. But later, as life changes, many women wish to have another baby and desire a tubal reversal, also called ligation reversal.

Sometimes women do not want a ligation reversal to have a baby, but they would like to reverse any problems that they have had as a result of the tubal ligation. Some women complain that they have worsened periods, increased weight gain, and tubal ligation syndrome (pain after a tubal ligation). Although a tubal reversal does not always result in fixing these issues, some women do feel better after tubal reversal surgery.