Tubal Reversal is an option for those patients who have had tubal sterilization surgery. These are primarily outpatient procedures and are generally considered low risk for complications. The majority of tubal reversals are performed via abdominal surgery (a small cut in the bikini area). Some Hospitals can use a Robot to reconstruct the tubes with similar efficacy, but the cost is usually prohibitive and more expensive than IVF. In some cases, Tubal Reversal can be performed with a Laparoscope, but many times the degree of difficulty to accurately stitch and re-approximate those tubes which are extremely can limit the success for some patients. Your doctor should have significant experience with these surgeries, and in general should be a Reproductive Endocrinologist/Infertility specialist as only but a few of us have significant experience.
Your fertility doctor will review your case and make that determination based on your medical history, and just as importantly consider the number of Cesarean Sections performed as these can significantly complicate the surgery. Smokers and significantly overweight people may experience problems with healing and is something your doctor will discuss at length with you. The type of tubal sterilization surgery will also be considered, as some sterilization surgeries will have better pregnancy rates than others. It should be noted that those who have at least 4cm of functional tubes after successful reconstruction have better outcomes. Those patient who had clips placed will in general have more than enough tube to work with. Those who had their tubes tied right after delivery in general will also have enough tube. Patients who had their tubes burned via Laparoscopy may be at higher risk of not having sufficient tube to work with. Rarely, the fingers at the end of the tube (fimbriae) are removed which are essential to pick up the eggs. If it is determined that these were removed, then Tubal Reversal surgery will be ineffective.
The majority of patients, about 90% can have at least one tube successfully reconstructed. It have been shown that Tubal Reversals are significantly more cost effective than IVF on a “baby per baby” basis, but the length of time needed to achieve a pregnancy is significantly longer with Tubal Reversal Surgery. Many patients desiring to start an immediate family may choose IVF, but this is a personal choice. About 60-70% of patients will achieve a live birth within the first 2 years. When a pregnancy is first determined, it is important to follow up with your doctor to ensure the pregnancy is not stuck in the tube (ectopic pregnancy) which can occur about 10% of the time.
Yes. Dr. Rudy Quintero is a Board Certified Fertility Doctor with years of experience performing tubal reversals. The procedure is an outpatient procedure (you go home the same day) and is done at our Glendale surgery center.
It‘s recommended to wait 2 – 3 days before going back to work or resuming your normal physical activities.