Tubal Ligation Reversal After 40 | Pregnancy and Infertility
Tubal ligation reversal is very successful at allowing women who have had their tubes tied to become pregnant again. In general, 70% of women who have their tubes untied at Chapel Hill Tubal Reversal Center become pregnant after reversal of tubal ligation. This overall statistic is based on all patients, but there is variation depending upon an individual’s age and method of tubal ligation.
Tubal Reversal and Pregnancy Success
The success of a tubal reversal procedure depends primarily upon two factors:
· Method of tubal blockage
· Age of the patient undergoing reversal procedure
Tubal Ligation Method
The majority of tubal ligation procedures are done by tying and cutting a small portion of the tube (ligation and resection) or by laparoscopic (camera) coagulation (burning). These procedures are very common in the United States. The cutting and removal procedures are usually done after having a baby, either during a c-section or after a vaginal birth. The laparoscopic procedures are usually done at some time after pregnancy. Despite what people – including medical professionals – think and tell others, the majority of these tubal ligations can be reversed.
Patient Age At Time of Reversal
As a woman ages, her ability to become pregnant gradually begins to decline. All women, regardless of age, have to take this into account when evaluating pregnancy options. Women over the age of 40, who are considering a tubal reversal procedure, have to factor in the increased pressure of time into their equation of pregnancy success.
Age and Fertility
The graph below illustrates the impact of age on the probability of getting pregnant (black line) and the converse likelihood of experiencing infertility (green line).
As a woman ages, her likelihood of pregnancy gradually decreases and the likelihood of infertility increases. After the age of 44, approximately 5% of women will become pregnant naturally. This graph is a good visual description of the impact of age upon a woman’s fertility. Women over the age of 40 should consider the above information when deciding tubal ligation reversal, IVF, or adoption as alternatives for pregnancy.
Our tubal reversal patients have had excellent success in becoming pregnant after reversal. We have statistics in our 2007 pregnancy report showing the number of our patients based on age successful at becoming pregnant and also comparing tubal reversal to IVF regarding pregnancy and birth rates.
Comments about Age and Pregnancy
The medical community has termed pregnancy in women over the age of 35 as ‘advanced maternal age’. The choice of age 35 was somewhat arbitrarily set by medical professionals to describe increased problems with pregnancy as women become older. The two main problems which increase with age are increased chances of a genetic abnormality and/or risks of a medical complication during pregnancy or delivery. Many women hear the term ‘advanced maternal age’ and feel the medical community is saying they are too old to become pregnant. Sadly, the term has evolved to have a negative connotation when discussing pregnancy in women of this age group.
I practiced high risk obstetrics for eleven years and the vast majority of women over the age of 35 have perfectly healthy and normal pregnancies. In my opinion, the problems associated with advanced maternal age started to noticeably appear after the age of 40- but even then, most of these women did great! Most of the problems I saw during my career were among younger women with severe medical problems.
Although it is true that at some point pregnancy is not biologically possible, biological limits are different for each person. There is no single medical test which can tell this us when someone is ‘too old’. We can never determine if someone will or will not get pregnant and, as a result, we do not impose arbitrary age limits for women to have a tubal surgery at Chapel Hill Tubal Reversal Center.
Readers are encouraged to comment on this blog and also to visit, participate, and share stories with other women on the Tubal Reversal Message Board.
The next article, Tubal Reversal After Age 40 – Adoption, will discuss the alternative of adoption. Following the adoption discussion, three articles will provide an overview of tubal ligation reversal: benefits, risks, and how to schedule. After discussing tubal reversal, we will then discuss IVF and IVF pregnancy results in older women.
Submitted by Dr. Charles Monteith
November 29th, 2009 at 1:29 pm
Tina
It is possible to have a tubal reversal and become pregnant after an endometrial ablation; however, if you had an endometrial ablation and you are not having periods then it is not possible to become pregnant with either tubal reversal or IVF.
The ablation removes the lining of your uterus. If you are not having periods then this means you do not have any uterine lining and pregnancy will not be possible. If your menstrual cycle returns then this means your lining has regenerated and then it may be possible to become pregnant with either tubal reversal or IVF.
There is no medical treatment to cause your uterine lining to regrow. If your uterine lining regrows then it is only because the uterine ablation was not very effective in removing your entire uterine lining. A significant number of women who have an ablation will have their menstrual cycle return within five years of the ablation. If it does not then it is only because your lining was effectively removed with the initial ablation procedure.
November 29th, 2009 at 12:13 pm
I had my tubes tied 9 years ago and had an ablation 2yrs ago also because of heavy bleeding. I haven’t had a period for 2yrs and now I met someone that I want to have a child with and would like to get a tubal reversal but is it possible to get this done with the ablation and become pregnant and carry full term?
September 27th, 2009 at 1:51 pm
Danie
You need to see a doctor right away if your pregnancy test is positive and you have already had a tubal ligation. There is a very high chance the pregnancy is in your tubes (ectopic pregnancy).
September 27th, 2009 at 1:31 pm
I am a 45 years old women with 3 children and have my tubes cut, clamped, and burned. I have not see my period for 3 months now? I have done a pregnancy test which is positive. I am scared to find out if am really pregnant, but I will welcome the baby anyway. I need to know if this is possible?
August 27th, 2009 at 11:49 am
Michelle
If you are still having periods after your endometrial ablation then a tubal reversal could give you a good chance of becoming pregnant. Pregnancies after an endometrial ablation are consider higher risk but many of these pregnancies do well.
Please call (919) 968-4656 for a free nurse consultation.
August 27th, 2009 at 9:34 am
I had my tubes tied about 13 years ago and an endometrial ablation done about 3 years ago. The ablation helped decrease my period but I still have one. Is there and way for me to be able to have a baby. Michelle
June 1st, 2009 at 12:00 pm
I am a 48yr old woman. I had my tubes tied in 1983 at the age of 21. I am now preparing to marry a great man that has no children and I desire to have a child for him. Is it possible.? I realize nothing is impossible with God. I will also like to know if you have success rates in such cases.
May 30th, 2009 at 5:55 am
BARBARA – We will be happy to help you. As you can see from the heading of our page, we are located in Chapel Hill, North Carolina. Here is a link to the Tubal Reversal Cost at Chapel Hill Tubal Reversal Center. You can call (919 968-4656 for a free consultation with a Tubal Reversal Nurse.
May 30th, 2009 at 2:20 am
I had a tubaligation reversal around 4 yrs & I’ve not been able to concieve due to 1 of my tubes are blocked. I’m needing to know where your office is & will you be able to help me to concieve & how much will it be.
Thanks, Barbara
May 7th, 2009 at 12:53 pm
CINDY R. – To answer your question, look at the Pregnancy Statistics after Tubal Reversal for our patients. If you have any other questions, you can call (919) 968-4656 for a free consultation with a Tubal Reversal Nurse.
May 7th, 2009 at 11:02 am
I have 2 kids and had my tubiligation in 1998. I am 39 and am engaged to be married. He doesnt have any kids. I am very active, and healthy. What are the possibilities of having a baby if I have my tubes reversed?
February 25th, 2009 at 4:52 am
Yes, it is probably true that a woman with proven fertility in the past is more likely to conceive again in her early forties than a woman who has never become pregnant or given birth. The latter case may be an indication of an underlying infertility problem.
February 24th, 2009 at 9:28 pm
When a women wishes to conceive in her early forties is the chance of conceiving higher provided she has given birth in the past, unlike a women who has never conceived and wishes to become pregnant?
February 10th, 2009 at 11:36 am
You have been able to explain age and fertility very well, Dr. Monteith, especially with the graph you submitted. The “biological clock” tends to add stress to our more mature patients, but as you have mentioned, age and fertility with conception can vary.
February 2nd, 2009 at 2:58 pm
This is a helpful article from Dr. Monteith. Many times women forget that some women don’t conceive naturally and are considered barren. Statistics determining the likelihood of pregnancy need to include all situations regarding infertility.
February 2nd, 2009 at 2:38 pm
Thanks for your questions Tamika and Derek.
Tamika
You are okay for surgery. We will perform out patient tubal reversal surgery on any women with a BMI less than 35.
You are correct in your BMI calculation; however, you might have misinterpreted the calculators classification. It calculated your BMI as 27.3 and put you in the “Overweight” category. These categories are determined by medical and insurance groups. Although they may consider you over the weight you should be based on your height, you are okay for surgery at Chapel Hill Tubal Reversal Center.
Derek
IVF has about a 30% chance of success per try and each try cost $9,000-12,000 dollars. Tubal reversal with our center, at this time is $4,900-5,900 and an average success of 70%.
In this blog series we will later discuss how many IVF experts will begin to recommend the use of donor eggs in the age range of 40-43. This has to also be considered when thinking of IVF. You have to have a consultation with your IVF expert to determine at what age they recommend the use of donor eggs.
February 2nd, 2009 at 2:18 pm
We are interested in having Dr. Monteith do our tubal reversal. I am a 40 year old woman and I had my tubal ligation done in 1995 at a hospital in the Bronx. I am overweight but I am trying to loose some weight before I schedule my surgery date. I was wondering how much weight do you suggest I lose with my weight being 164lbs? I am 5′5″. According to the BMI chart my score showed 27.5.
This is from my fiance Derek he would like to know is this the best thing for us to do or would IVF work better for a woman my age?
February 1st, 2009 at 10:21 pm
Lorraine – You can contact the hospital where you tubal ligation was performed using the Medical Records Release Form. If you are unable to obtain the operative report, we can start the procedure with screening laparoscopy.
February 1st, 2009 at 10:19 pm
An operative report is preferred but not mandatory. You would contact the hospital where your tubal ligation was done. Some hospitals will destroy records after a certain time frame. In this case, many patients will come for surgery without their operative reports or they will consider a screening laparoscopy to evaluate the condition of their tubes prior to a abdominal incision.
February 1st, 2009 at 10:04 pm
I am a 43 year old, divorced for 4 years. I had my tubes tied 9 years ago after the birth of my last child. I am now engaged to a wonderful man and we have discussed that we would like to have a baby together. I realize that the odds are slimmer due to my advanced age but I’d like to try all the same. I’m not sure about the kind of tubal ligation I had. I have relocated to another state. Would I contact the hospital or would I need to contact the obgyn office? Is there a way to determine this if I am unable to obtain my records?
January 31st, 2009 at 4:40 pm
Thanks for your comment Lynne.
The source for the graph was The Fertility Sourcebook by M. Sara Rosenthal. Although the graph was shown in the book, the source of the data was not provided.
I began researching the topic of the effect of age on fecundity late last summer. I was not able to find a single visual representation or medical publication of the impact of age on fecundity or infertility. This graph was the only one we had on file and we decided to use it because it provides a visual representation of what we all know to be true. If any reader can provide us any recent data on fecundity and age, then we would be very appreciative.
The graph should not be overly interpreted because determining fecundity is hard. It is inherently difficult to determine what the likelihood of pregnancy is in a given age group- it is hard to measure and is fraught with bias. It is even more difficult in a group of older women because a large number of these women will not be trying, will have had tubal ligations or hysterectomies, or may have severe medical problems.
The numbers represented in the graph should not be taken verbatim but, more importantly; they provide an approximate representation of the observation of decreasing ability to become pregnant as a woman approaches menopause.
January 31st, 2009 at 4:25 pm
Tristana
We hear stories like these all the time from patients.
There is hope for you. Your tubal ligation can be reversed and pregnacy is possible. If you send us a copy of your tubal ligation operative report (if available), then we can help you. Even if a patient can not get their operative reports, then the majority (98%) of the time their tubal ligaitons can be reversed.
January 31st, 2009 at 4:03 pm
I had my 5 children very young and my twins were born in 1990. I didn’t realize at the time what was going on, but was told at Bay Front hospital to under go surgery and the next thing I know they had went through my navel and did a tubal ligation. I was very upset about this because I was told a lie. I never signed any agreement. Now its been years and I just got married 2 months ago. My other kids are all grown up now and would love to have another baby. Please tell me someone can help?
January 30th, 2009 at 2:09 pm
That graph is really interesting! I’d love to know where you got the information and see it in written form as well. Do you have a citation?
January 30th, 2009 at 11:22 am
I love the graph! It really does give a good visual explanation of the effect age may have on fertility.
Thank you.
January 30th, 2009 at 7:52 am
Thank you Dr. Monteith! I think that this information will be comforting to the readers. It is straight forward and honest! You are absolutely correct in that we can not determine if someone will or will not become pregnant. However, since we have patients that have the tubal reversal for reasons other than conception, it is important that they understand why we do not impose an age limit.