Chapel Hill Tubal Reversal Center
109 Conner Drive Suite 2200, Chapel Hill, NC 27514 (919) 968-4656

Tubal Ligation Reversal Blog

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).

Graph for patients considering tubal ligation reversal surgery illustrating increasing infertility and decreasing likelihood of pregnancy with advancing age.

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

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24 Responses to “Tubal Ligation Reversal After 40 | Pregnancy and Infertility”

  1. Charles Monteith MD Says:

    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).

  2. danie Says:

    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?

  3. Charles Monteith MD Says:

    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.

  4. Michelle Says:

    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

  5. Rosa Says:

    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.

  6. Dr. Berger Says:

    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.

  7. BARBARA Says:

    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

  8. Dr. Berger Says:

    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.

  9. Cindy R. Says:

    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?

  10. Dr. Berger Says:

    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.

  11. Michelle Thomas Says:

    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?

  12. Kathy Says:

    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.

  13. Jan Says:

    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.

  14. Charles Monteith MD Says:

    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.

  15. Tamika and Derek Says:

    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?

  16. Dr. Berger Says:

    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.

  17. Charles Monteith MD Says:

    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.

  18. Lorraine Says:

    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?

  19. Charles Monteith MD Says:

    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.

  20. Charles Monteith MD Says:

    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.

  21. tristana Says:

    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?

  22. Lynne Says:

    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?

  23. Pamela Mills, CRNA Says:

    I love the graph! It really does give a good visual explanation of the effect age may have on fertility.
    Thank you.

  24. Ericka Pamplin Says:

    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.

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Chapel Hill Tubal Reversal Center.
109 Conner Drive Suite 2200, Chapel Hill, NC 27514
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