Almost every article one reads about tubal ligation stresses that it is permanent. Most doctors and the lay public believe this to be true. In my experience, however, tubal ligation is reversible in over 95% cases!

Doctors stress that tubal ligation is a permanent method birth control because it cannot be discontinued easily such as stopping the use of birth control pills or the patch, removing an IUD, or avoiding the use of barriers contraceptives (condom or diaphragm). In the past, reversing a tubal ligation procedure involved complicated surgery with its attendant high cost (up to $35,000). The outpatient tubal ligation procedure that I have developed is uncomplicated surgery and avoids the expense of hospital charges. This has reduced the cost of tubal reversal surgery to under $6000. This is less than the cost of a single treatment cycle with in vitro fertilization (averaging $10,000 - $12,000). My effort over the past 3 decades has been to make tubal reversal surgery easy to undergo and affordable for couples.

There are some methods of female sterilization that are not reversible. These include complete removal of the fallopian tubes (total salpingectomy) and extremely destructive methods of partial salpingectomy that do not leave two segments to repair. An example of the latter is when only a short portion of the tube is attached to the uterus and the remaining segment contains only fimbrial tissue with no tubal muscle or opening. In this case, the fimbrial tissue alone cannot be rejoined successfully to the uterine segment of tube. Fortunately, this is an unusual occurrence. In cases where there is a sufficient length of tube attached to the uterus, it can be opened and be able function normally even without the fimbrial end. This is called ampullary salpingostomy. This technique is useful in reversing a fimbriectomy (removal of the fimbrial or ovarian end of the fallopian tube).

Reviewing the operative report from a tubal ligation procedure usually will indicate how destructive the procedure was. When there is a question about this, diagnostic laparoscopy can be performed to examine what remains of the fallopian tubes. If there are sufficient segments to repair, tubal reversal can be done right then while the patient is under anesthesia.

The best method of tubal ligation to reverse is the clip procedure. The Hulka Clip was developed in the 1970s by Dr. Jaroslav Hulka, a professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill. (Dr. Hulka was one of my most influential teachers during my residency in ob-gyn at UNC.) The tubal ring also is an excellent method for reversing. The clip and ring procedures tend to damage the least amount of the fallopian tube and leave behind long segments to repair.

The most common tubal ligation procedures involves tying and cutting the tubes (ligation/resection) or burning the tubes (coagulation). Experience shows that 98% of these procedures are reversible.

Summary: Tubal ligation is not really permanent in the sense that it can be reversed in almost all cases. This is fortunate for those women who want another chance to have a baby after having their tubes tied. Tubal reversal is more successful, less complicated, and less expensive than the alternative treatment of in vitro fertilization.

How Fertility is Restored Through Outpatient Tubal Reversal

This video clip comes from a Discovery Channel production featuring the tubal reversal procedure that I perform. The film crew followed Deborah and Paul Martinez as they proceeded through their tubal reversal journey. The operation was filmed in its entirety and I describe each step as I proceed through the procedure. The video clip available here is only 3 minutes in length, but the entire operation is available in a free videotape or DVD. Originally aired as part of the series, “The Operation”, the film has also been broadcast on TLC (The Learning Channel) and on “The CBS Early Morning Show”.

The video tape or DVD is free of charge for personal viewing. There is a small charge for shipping and handling.

This video shows step-by-step how I repair the fallopian tubes after a tubal ligation in a one-hour outpatient procedure that is comfortable for the patient and results in very quick recovery.

Once you see this you will understand why patients come to Chapel Hill Tubal Reversal Center from all over the US as well as from other countries for their tubal reversal procedure. Besides its comfort and fast recovery, my procedure has the highest success rates of any operation to repair the tubes and it more successful than the alternative (and more expensive) treatment of IVF.

http://video.tubal-reversal.net/

People often wonder “If I do get the tubal reversal procedure done, what are the chances I’ll conceive?”

Dr. Berger is the only doctor who tracks his specific success rate - others doctors will just quote what has been published elsewhere or what they think the success rate should be. Dr. Berger has taken the time and the expense to meticulously keep track of his patients’ pregnancies needed to determine the success rate of the tubal reversal procedures he has performed.

Success Rates

One way to estimate your probability of success after a tubal reversal procedure is from the operative report from your tubal ligation. This can be obtained from the doctor who performed the surgery or from the medical records department of the hospital where your procedure was performed.

If you would like to forward this information to us, Dr. Berger will review the operative report at no charge and we can contact you regarding possible outcomes for you following reversal surgery. You may fax the records to us at 870-934-9211. Please include all contact information (phone and e-mail) when faxing your records.

If you have questions about your chances to get pregnant after a tubal reversal, please feel free to contact me.

Julia Smith, RN
Nurse Administrator
Chapel Hill Tubal Reversal Center
Phone: (919) 656-8204
Fax: 870-934-9211

Have you seen my tubal reversal lens on Squidoo.com? It has key information about tubal reversal. Here are some excerpts.

Tubal Reversal Success

There is just one way to know what the success after tubal reversal surgery is - and that is by documenting pregnancy and birth rates. This requires long term patient follow-up. Our ongoing follow-up system records the outcomes of every reversal procedure and provides the results for all to see. We are the only medical facility that does this! Chapel Hill Tubal Reversal Center publishes weekly pregnancy reports and pregnancy statistics that include pregnancy rates and pregnancy outcomes for my patients.

Making Surgery Comfortable for the Patient

Tubal reversal surgery traditionally has been a major operation with several days of recovery in a hospital due to postoperative pain and disability. These can be avoided.

Postoperative pain following abdominal surgery comes mainly from muscle and connective tissue injury. Abdominal retractors (metal instruments that pull back on the skin, connective tissues, and muscles) are traditionally used to give wide exposure to the pelvic organs during surgery. Pressure from abdominal retractors causes reduced blood flow to the retracted tissues, resulting in postoperative pain. The operation is best performed without retractors.

Surgical packs (large gauze pads) traditionally are placed into the abdomen to push the intestines away from the pelvic organs during surgery. Packs cause postoperative bloating due to intestinal irritation. These can be avoided also.

Injecting a local anesthetic where surgery is performed - even though the patient is asleep during the procedure - further minimizes postoperative pain. (This is called preemptive analgesia.) These are some of the ways I make tubal reversal surgery comfortable for patients. Making surgery comfortable improves recovery, avoids the need for hospitalization, and results in a low cost tubal reversal procedure.

An Excellent Reference Source

At Chapel Hill Tubal Reversal Center, we provide complete and accurate information about tubal ligation reversal. Here are some starting places:

VIP Questions
Pregnancy Testimonials
Tubal Reversal Illustrations

Tubal Reversal or IVF

Our follow-up pregnancy statistics from over 5000 tubal reversal patients show that tubal reversal is more successful than IVF. This is because once the tubes are repaired, there is a chance every month of conceiving naturally. The pregnancy rate is higher after tubal reversal than after IVF for women iof all ages. Furthermore, the cost is much less than a single IVF treatment cycle.

Pregnancy Rates After Tubal Reversal vs IVF

Tubal Reversal IVF

This blog is to share observations, experiences, and thoughts about tubal ligation reversal developed over the 30 years I have been performing tubal surgery. Others are welcome to contribute their own ideas, opinions, and questions.

Gary S. Berger, M.D.
Medical Director
Chapel Hill Tubal Reversal Center
109 Conner Drive Suite 2200
Chapel Hill, NC 27514