On Tubal Reversal: IVF Or Sterilization Reversal?
This is a continuation of the series discussing pregnancy options for women considering tubal ligation reversal or in vitro fertilization (IVF).
This series of articles has been written by Dr. Charles Monteith and Dr. Gary Berger, the tubal reversal doctors at Chapel Hill Tubal Reversal Center.
We continue with these blog articles to cover all topics related to regaining fertility after tubal ligation. We want our patients to be well educated so they can make informed decisions about their options when they want more children after having their tubes tied.
IVF Using Donor or Nondonor Eggs
This article examines pregnancy rates obtained with IVF when women use their own (nondonor) eggs vs using donor eggs.
Effect of Age on Pregnancy Rates after IVF
IVF can be a beneficial treatment for infertility in women of older ages. In most cases, however, donor eggs must be used to obtain high pregnancy rates provided by IVF.
The graphs shown in this series come from the Centers for Disease Control (CDC) 2006 National Summary and Fertility Clinic Reports Study. The CDC monitors assisted reproductive outcomes on a yearly basis across the United States and keeps extensive statistics on IVF outcomes. The following graph shows pregnancy rates by age among IVF patients in the US using nondonor eggs (patient’s own eggs).
IVF Pregnancy Rates Decrease With Age
“Pregnancy” is defined as any developing embryo seen in the uterus with ultrasound in the first trimester.
“Live birth” is the birth of any child that survives and includes multiples and preterm births.
“Singleton live birth” is the birth of any singleton infant which survives (term or preterm).
The Bottom Line
As women get older, IVF pregnancy and live birth rates using nondonor eggs decline. At age 40, the live birth rate is 16%. By age 44, the live birth rate after IVF with nondonor eggs is less that 1%.
Higher IVF Pregnancy Rates When Using Donor Eggs
IVF success rates among women of all ages are higher when donor eggs (eggs from another woman younger than 30) are used (squares). The average live birth rate among all ages when using donor eggs is around 50%.
The live birth rate when nondonor eggs (patient’s own eggs) are used (circles) begins to decrease gradually between 30-35 years of age and decreases more sharply after the mid-30s. By age 42, the IVF live birth rate using non donor eggs is about 8% and by 44 is only about 0.8%. As a result, many IVF providers will encourage older women to consider donor eggs when undergoing IVF treatments. Some infertility specialists encourage donor egg usage in patients as young as 40 and some will encourage donor egg use starting between the age of 42-43.
Tubal Reversal Surgery or IVF?
We have previously published discussions on our experience with:
Pregnancy success rates of tubal ligation reversal and on
Pregnancy rates after repair of damaged fallopian tubes
Sterilization reversal procedures provide comparable and, in many cases, superior pregnancy rates when compared with IVF.
Readers are encouraged to view the entire series of articles on tubal reversal in older women. The first article of this series is Tubal Ligation Reversal After the Age Of 40| Introduction.
The next article, Does Tubal Reversal Work?, will provide a comprehensive overview of the success of tubal reversal and directly compare rates of pregnancy success after reversal to rates of pregnancy success with IVF when using both nondonor and donor eggs.
Personal Stories About Tubal Reversal
Many personal stories about having a tubal reversal can be found on our Tubal Reversal Blog. Readers are invited to join discussions with other women on our Tubal Reversal Message Board.
October 2nd, 2009 at 8:17 pm
[...] Unfortunately, many women are told in order to conceive a child it will have to be IVF. The reason for this may be that many physicians are just not being trained in tubal surgery [...]
June 7th, 2009 at 6:14 pm
Having a cycle day 3 FSH level will tell you if you still have a reservoir of healthy eggs. The cost for IVF varies greatly throughout the US. I don’t know what the cost for IVF is in England.
June 7th, 2009 at 3:26 pm
Now that I know that I no longer can have tube reconstruction and you have said that the best way for me is IVF, i know that you state about the birth rate, but i am 45 in very good health have regular periods and would like to use my own eggs. Is there a test that you do to see if the eggs are good. I really want a child with my new husband and i know in England they are a bit funny about older women and IVF or have other children also what is the cost for IVF? Many thanks you all do a great job.
April 28th, 2009 at 3:23 am
[...] The tubal reversal specialists of Chapel Hill Tubal Reversal Center continue their series on tubal ligation reversal after the age of 40. This article examines the pregnancy rates of IVF when using nondonor and donor eggs … more… [...]
April 24th, 2009 at 3:43 pm
[...] next article in our series, On Tubal Reversal: IVF Or Sterilization Reversal, will compare the success of IVF after the age of 40 when using donor and nondonor [...]
April 20th, 2009 at 9:55 am
Dr. Monteith, thanks for providing this information to assist women who are trying to regain fertility after tubal ligation. Your work to help patients make a well educated decison is to be commended.
April 17th, 2009 at 10:42 am
I was told by an IVF doc, that my chances with IVF were under 5%. Maybe I’m in denial, but my fsh level was 10 (normal) but my AMH level was very low. I am 42 soon to be 43 and I’m having my tr on 5/18 with Dr. B. I would like to be positive, but I must be realistic. How long do you wait after tr for the next step? I have regular periods, always have, have 1 daugher 16 and twins naturally 14. What are my chances for one more?
April 17th, 2009 at 8:22 am
Thanks for your information and graphs on IVF, Dr.Monteith. You continue to show that with information, considerations can be made with choices one has for conceiving again after tubal ligation.
April 17th, 2009 at 6:26 am
Thank you, Dr. Monteith. I am looking forward to the next article. I agree with Pam, these articles will be very helpful in making an informed decision.
April 17th, 2009 at 4:45 am
Another great article by Dr Monteith. The continuation of this series is so important for ladies who want to make an informed decision about tubal ligation reversal.
April 16th, 2009 at 9:58 pm
I am glad to read the continuing information on the risks, benefits, and alternative approaches for having a baby after a sterilization.
April 16th, 2009 at 9:34 pm
Brenda
As long as you have regular periods then pregnancy is always possible; however, at the age of 49 IVF using donor eggs provides the best chance of having a pregnancy. Pregnancy rates with natural conception at the age of 49 is extremely low- less than 1% chance. When using donor eggs and IVF pregnancy rates can be as high as 50% at the age of 49.
April 16th, 2009 at 9:29 pm
I was told by my doctor that I cannot have a baby because I am 48 yrs old. I had my tubes tied when I was 22. And I have been thinking about one more child. Is it possible for me to get pregnant at the age of 49?