Archive for the ‘pregnancy after tubal reversal’ Category
Saturday, April 5th, 2008
Tubal reversal information is plentiful on the internet, but not everything that you read is accurate or factual. Of the websites that provide information about tubal ligation reversal, the one from Chapel Hill Tubal Reversal Center is most complete and accurate. It describes the various types of tubal ligation procedures and the different tubal reversal procedures that can be used. If you are interested in learning about tubal reversal, spend some time looking at the different pages on this extensive site. There is a search box at the top of every page that can direct you to specific information about any issues relating to tubal ligation reversal. Take a look also through the many topics of information on the Tubal Reversal Blog.
Tubal Reversal Surgery
Tubal ligation reversal is usually considered to be a major operation, taking several hours and requiring a hospital stay of 1 to 5 days. Complete recovery is often described as taking 4 to 6 weeks. However, the tubal reversal procedure that Dr. Berger has developed is performed as outpatient surgery with no hospital stay required and with complete recovery generally within 5 to 10 days. Since hospitalization is not required, the cost of the tubal reversal procedure is reduced by half or two-thirds of the cost when performed in a hospital. Patients are more comfortable during their post operative recovery and are able to return to work and other normal activities much faster. A free video or DVD of Dr. Berger’s tubal reversal procedure is available on the Chapel Hill Tubal Reversal Center website.
Risks of Tubal Reversal
As with any surgery, complications are always a possibility. Although rare, these may include bleeding, infection, damage to other organs, or complications of anesthesia. The most significant risk associated with tubal ligation reversal is the long term risk of having an ectopic pregnancy. This risk is increased from approximately 2% of pregnancies in the general population to approximately 10% after tubal reversal. Fortunately, the medical problem of a ruptured tubal pregnancy can be prevented by following an early pregnancy monitoring protocol that has been described by Dr. Berger and is recommended to all women after a tubal reversal procedure.
Alternative Treatment
Rather than “untying” their tubes, some women are advised to be treated by in vitro fertilization (IVF). However, IVF is more complicated and expensive, the pregnancy rate after IVF is not as high as after tubal reversal, and there is a very high incidence of multiple births (approximately 30%) after IVF. Further, there is concern about the possible long term effect of the use of potent hormones to stimulate the ovaries to produce many eggs (called “super-ovulation”) and the suspicion that it might increase the risk of ovarian cancer later in life.
Am I a Candidate for Tubal Reversal?
Although most women have been told that tubal ligation is permanent, in fact, the vast majority of tubal ligation procedures are reversible. The operative report from your tubal ligation will give a good indication if the procedure can be reversed. When there is any doubt about this, diagnostic laparoscopy can be performed to examine the fallopian tubes and then decide whether to proceed with the reversal operation.
Pregnancy Rates After Tubal Reversal
Pregnancy and birth rates after a tubal reversal are significantly better than after IVF. Neither procedure, however, can guarantee that pregnancy leading to birth will occur. Even when the fallopian tubes have been repaired, other factors – such as age, menstrual cycle regularity, ovulation or other hormonal disorders, and the fertility of the male partner - may determine when, or whether, conception will occur.
Women under the age of 30 who have a tubal reversal have an 82% pregnancy success rate; between 30-34 the pregnancy rate is 76% and for women ages 35-39, the pregnancy rate is 67%. The pregnancy rate declines for women 40 and older in accordance with the natural decline in fertility with age. However, pregnancy rates are higher for women of any age following tubal reversal than after IVF.
More Tubal Reversal Information
If you would like to discuss your individual situation with a Tubal Reversal Nurse, call (919) 968-4656. The experienced nurses at Chapel Hill Tubal Reversal Center are always happy to provide information about tubal ligation reversal. You can also exchange information with other women on the Tubal Reversal Message Board.
Tags: chapel hill tubal reversal center, dr berger, early pregnancy monitoring, ectopic pregnancy, in vitro fertilization, ivf, ovarian cancer, pregnancy, pregnancy monitoring protocol, preventing tubal rupture, ruptured tubal pregnancy, tubal ligation procedures, tubal ligation reversal, tubal reversal, tubal reversal cost, tubal reversal information, tubal reversal procedures
Posted in dr berger, ivf, pregnancy after tubal reversal, tubal ligation, tubal reversal cost, tubal reversal illustrations, tubal reversal procedure, tubal reversal surgery | 11 Comments »
Saturday, January 19th, 2008
Past topics in the Tubal Reversal Blog include posts and comments about patient care at Chapel Hill Tubal Reversal Center. This topic summarizes important articles about tubal ligation and tubal reversal reported in the news during 2007.
Sterilization is Most Popular Family Planning Method
Approximately 10 million American women use the pill for contraception, while sterilization has been chosen by 15 million men and women.
One In Five Women Regret Decision For Tubal Ligation
One in five women under age 30 who undergo tubal sterilization later regret the procedure, despite the number of children they have.
Is Sterilization the Best Contraception Choice?
Women requesting a tubal ligation should be counseled regarding other long-term, reversible methods of contraception and informed that vasectomy is safer and more effective than tubal ligation.
Tubal Ligation Counseling Issues
Counseling about tubal ligation should include permanence of the method, possibility of future regret, and information about the specific techniques of tubal sterilization.
Relationship Conflict Before Sterilization
Women whose relationship was marked by substantial conflict before they underwent tubal ligation were most likely to regret the decision.
Young Age, Prodding Partner and Sterilization Regret
Young age and a prodding partner are risk factors indicating that a woman undergoing sterilization may later regret her decision.
Tubal Reversal Among Overweight Women
Overweight women’s chances of becoming pregnant after tubal reversal improve when they lose weight.
Dr. Berger’s Comment
These news reports touch on some of the issues patients talk about when they come to Chapel Hill Tubal Reversal Center for tubal sterilization reversal. The popularity of tubal ligation, and the fact that many women regret their decision to have a tubal ligation, are well documented. Young age and marital conflict are risk indicators for subsequent regret. Before performing a tubal ligation, doctors should ensure that the implications of ending childbearing potential are clearly understood and discuss vasectomy as an alternative permanent method of birth control. Women undergoing tubal reversal who are overweight should be aware that losing weight will improve their chances of becoming pregnant again.
Tags: counseling, female sterilization, news items, news reports, news stories, sterilization, sterilization regret, tubal ligation counseling, tubal ligation news, tubal ligation regret, tubal reversal news, tubal sterilization
Posted in media coverage, pregnancy after tubal reversal, tubal ligation, why tubal reversal | 6 Comments »
Monday, January 14th, 2008
Women come from all over the world to Chapel Hill Tubal Reversal Center for tubal reversal surgery. It is natural, and appropriate, for them to ask what their chances will be for pregnancy after a tubal reversal procedure performed by Dr. Berger. This important question about the anticipated benefit should be asked of any doctor before undergoing elective surgery. When answering questions about pregnancy after tubal reversal, we provide detailed information including pregnancy rates and their supporting data.
What Is The Success of Tubal Reversal?
There is only one way this question can be answered, and it requires ongoing follow up with patients to learn the results of their tubal reversal procedures. At Chapel Hill Tubal Reversal Center, we take this task to heart. Our nurses contact patients repeatedly during the first year after their surgery. When a patient informs us of a new pregnancy, we ask her to complete a Pregnancy Report Form. From this information, we provide a summary on the Weekly Pregnancy Reports Forum. The Weekly Pregnancy Report lists the age, date of tubal reversal, date of positive pregnancy test, method of tubal ligation, and tubal lengths after tubal repair for each pregnant woman. Additional comments about these pregnancies are shown in the Pregnancy Announcements.
Our various pregnancy information forums allow people to see the results from tubal reversal surgery performed by Dr. Berger on an current basis. The reports are not “filtered” to show only successful pregnancies. They include information about miscarriages and ectopic pregnancies as well. We want people to be fully informed about all of the possible outcomes after tubal reversal. One of our missions at Chapel Hill Tubal Reversal Center is to provide complete and accurate information about all aspects of tubal reversal surgery!
Pregnancy and Baby Testimonials
Some patients send us messages accompanied by photos after they have delivered their babies. These are spontaneous reports. Although we don’t ask patients to send us testimonials, we love receiving and reading them! They are added to the Testimonials section of our site for others to enjoy as well. Currently there are about 700 testimonial pages.
Testimonials Pages
When a patient sends us a birth announcement and photo to be added to Pregnancy and Baby Testimonials, we update an index page so that there is a link at the top of the page to the newest baby testimonial. The index page is what visitors see first when they click on any link to Testimonials. This page has brief quotes with a link to the full testimonial for each patient. We limit the index page to about 30 summaries. To see previous testimonial index pages, click the “Next” link at the bottom of the page. This will show the immediate prior group of testimonial quotes and links. Currently there are 48 testimonial index pages. To see a listing of all the testimonials, look at the Testimonials Site Map.
Our patients share so many different stories about their pregnancies and deliveries after their tubal reversal procedures. Most people don’t realize how many testimonials there are (689 as of January 13th, 2008. The testimonial number is shown in the “bread crumb” at the top left hand side of the page.) To protect patients’ privacy, only the first initial of the last name is shown. Many women include their email addresses and are happy to correspond with others about their experience here.
Pregnancy and Birth Statistics After Tubal Reversal
Since pregnancy and its outcome are the primary concerns of most women who come here for a reversal procedure, we do everything possible to obtain and report this information on an ongoing basis. This keeps us informed about the number of pregnancies and what their outcomes were after tubal reversal. It also allows us to answer questions and guide patients who are waiting to become pregnant. This takes the efforts of a dozen nurses each day, in addition to their care of patients who are preparing for and undergoing surgery. No other medical facility has undertaken this effort.
As a result of the efforts of our staff and patients, we are able to perform careful analysis and report accurate statistics regarding pregnancy rates and births rates after tubal reversal procedures performed by Dr. Berger. This is referred to as “evidence based medicine”. It is consistent with our mission, and is one of the many reasons why Chapel Hill Tubal Reversal Center has become known as the best place to have tubal reversal surgery.
Tags: birth, birth rates, birth statistics, births after tubal reversal, chapel hill tubal reversal center, dr berger, ectopic pregnancy, miscarriage, pregnancy after tubal reversal, pregnancy outcomes, pregnancy rates, pregnancy statistics, tubal reversal birth rates, tubal reversal pregnancy rates
Posted in pregnancy after tubal reversal | 7 Comments »
Wednesday, December 12th, 2007
Tubal ligation was intended to be permanent. Circumstances can change and women with tied tubes may want more children. When this happens, they often are told that treatment by in vitro fertilization (IVF) is their only option. In reality, tubal reversal is the best choice.
Comparing Tubal Reversal and IVF
Once the fallopian tubes are repaired by tubal reversal surgery, there is a chance every month for pregnancy to occur naturally. This is why tubal reversal is more successful than IVF.
IVF requires a woman to have weeks of hormone injections to produce many eggs each time pregnancy is attempted. The pregnancy rate with IVF is approximately 25% per treatment cycle. Most women require multiple IVF treatments to become pregnant. At a cost of $12,000 per cycle, this treatment becomes expensive very quickly!
The overall pregnancy rate among Dr. Berger’s tubal reversal patients is 70%, and the cost of a tubal reversal procedure is less than half that of a single IVF treatment cycle. This graph shows that pregnancy rates are higher after tubal reversal performed by Dr. Berger than after IVF. This is true regardless of a woman’s age.
Pregnancy Rates by Age After Tubal Reversal vs IVF
Tubal Reversal
IVF

Conclusion About Tubal Reversal vs IVF
Tubal reversal has a higher pregnancy rate then in vitro fertilization and is much less expensive when performed at Chapel Hill Tubal Reversal Center.
Are There Hidden Costs of Tubal Reversal?
The discounted fee when paying in full at the time you schedule tubal reversal at Chapel Hill Tubal Reversal Center is $5900. This is an all-inclusive fee. There are no hidden charges! The fee covers the following:
Preoperative record review and consultation
Dr. Berger’s surgical fee
Anesthesiologist’s and nurse anesthetist’s fees
Surgical supplies
Operating facility fees
Postoperative pain medication and antibiotics
Follow-up care
What To Expect at Chapel Hill Tubal Reversal Center
Most of our patients come to Chapel Hill from other states and from other countries. To minimize the time you spend here, your preoperative consultation will be scheduled for the day preceding your tubal reversal. On the day of your reversal procedure, you will spend the morning at Chapel Hill Tubal Reversal Center and the rest of the day at your hotel room at the Sheraton-Chapel Hill. The following morning, one of our nurses will visit you at your hotel for a postoperative check prior to your returning home. You will be here for two nights, on the day prior to surgery for your preoperative consultation and on the day of your tubal reversal procedure.
I Will Be Happy To Assist You
If you would like additional information or would like to schedule your tubal reversal procedure, please feel free to contact me. You can reach me from 8 am to 8 pm Eastern Time at (919) 656-8204 or by e-mail at JuliaS@tubal-reversal.net. I will be glad to answer any questions you might have!
Submitted by Julia Smith, RN
Nurse Administrator
Tags: chapel hill tubal reversal center, in vitro fertilization, ivf, pregnancy rates, tied tubes, tubal ligation reversal, tubal reversal, tubal reversal cost, tubal reversal fee
Posted in ivf, pregnancy after tubal reversal, tubal reversal cost | 1 Comment »
Tuesday, December 11th, 2007
If you have had your tubes tied and would like to become pregnant again, tubal reversal surgery is probably the best option for you. Tubal ligation reversal is the most successful and cost-effective way to become pregnant for 98% of women who have had a tubal ligation and now want to have another baby.
What Is Your Age?
The natural fertility rate declines with age. Pregnancy rates after tubal reversal, therefore, are highest for younger women. Although pregnancy rates are lower for older women, you can still become pregnant after age 40 if you are ovulating and have periods.
Dr. Berger has kept detailed records of his patients and has compiled a comprehensive follow-up study on pregnancy after tubal reversal for all of his patients. His patients under 30 have a 77% pregnancy rate after having a tubal reversal procedure. The pregnancy rate is 72% for women ages 30-34 , 62% for women 35-39, and 34% for those 40 years of age and older after tubal reversal surgery performed by Dr. Berger.
What Type of Tubal Ligation Did You Have?
There are several ways that a doctor can tie a woman’s fallopian tubes. Women with the ring or clip method of tubal ligation have a 74% pregnancy rate after undergoing tubal reversal surgery. Women with the tubal coagulation technique have a 65% pregnancy rate, while women with tubal ligation and resection methods have a 62% probability for pregnancy after reversal surgery.
If you aren’t sure what type of tubal ligation you had, don’t worry! You can get a copy of your operative and pathology reports relating to your tubal ligation, and fax them to Chapel Hill Tubal Reversal Center at (919) 967-8637. Please attach the Fax Cover Sheet so we can reach you when your records arrive. Dr. Berger will review the operative report at no charge and we will contact you regarding possible outcomes for you following reversal surgery.
How To Choose The Best Tubal Reversal Doctor?
The most important question to ask is how many tubal reversal surgeries the doctor has performed. The more experience the doctor has, the better your outcome will be. Dr. Berger has the most experience with this operative procedure of any reproductive surgeon in the world and has performed more than 6,000 tubal reversals! He is considered by other medical professionals in the US and abroad to be the best tubal reversal doctor.
Also ask if the doctor performs tubal reversals on an outpatient basis. Outpatient tubal reversal reduces cost and avoids the risks of hospitalization, such as infection with hospital-acquired bacteria. Chapel Hill Tubal Reversal Center is the only center worldwide that is dedicated exclusively to outpatient tubal ligation reversal, and Dr. Berger is the only doctor who specializes in and limits his practice to outpatient tubal reversal surgery.
I Will Be Happy To Assist You
If you would like additional information or would like to schedule your tubal reversal procedure, please feel free to contact me. You can reach me from 8 am to 8 pm Eastern Time at (919) 656-8204 or by e-mail at JuliaS@tubal-reversal.net. I will be glad to answer any questions you might have!
Submitted by Julia Smith, RN
Nurse Administrator
Tags: age, best tubal reversal doctor, cost-effective, dr berger, fallopian tubes, fertility, fertility rate, outpatient tubal ligation reversal, outpatient tubal reversal, pregnancy after tubal reversal, pregnancy rate, pregnancy rates, tied tubes, tubal ligation, tubal ligation reversal, tubal reversal, tubal reversal doctor, tubes tied
Posted in pregnancy after tubal reversal | No Comments »
Friday, December 7th, 2007
Chapel Hill Tubal Reversal Center Mission
Chapel Hill Tubal Reversal Center is the only medical facility specifically for tubal ligation reversal surgery. We provide the most detailed information about tubal reversal available from any doctor, hospital, or medical institution. This blog post describes how we are able to do this.

Electronic Patient Database
Keeping track of patients following surgery makes sense from a clinical point of view. Continuing follow-up after surgery helps ensure the best patient care. It also allows us to evaluate the success of tubal reversal surgery and the care we provide. Setting up and maintaining a system for ongoing patient follow-up is not usually found in a private medical practice. It is costly, time-consuming, and requires staff knowledgeable in database management. Despite the cost and time requirements, I have made it a priority because of my commitment to giving patients all of the information they should have to make informed decisions about tubal reversal surgery.
At Chapel Hill Tubal Reversal Center, we have a computer system where every nurse enters patient information before, during, and after tubal reversal procedures. All 11 of our nurses contact patients, record data, and make daily entries into computerized records. With this follow-up information, I can analyze and report accurate statistical data about the long-term outcomes of the tubal reversal procedures I have performed.
Information Sources
The patient follow-up system consists of information collected in many different ways and includes a minimum of 6 calls or e-mails to every patient in the first year following surgery:
- Post-operative nurse visit the morning after surgery;
- Telephone follow-up on the second postoperative day;
- Telephone follow-up on the third postoperative day;
- E-mail questionnaire at two weeks;
- Telephone contact at 6 months;
- Telephone contact at 12 months.
Other information is collected and recorded any time we communicate with patients post-operatively. These contacts are usually initiated by patients to report pregnancies and the outcomes of pregnancies. When patients report new pregnancies, we request that they complete a Pregnancy Report Form. Each week, we list the new pregnancy results in the Weekly Pregnancy Report Forum of the Tubal Reversal Message Board and also give more details in the Weekly Pregnancy Announcements.
Summary
After reading our information and statistics and comparing it to what might be available from other doctors, we believe patients will recognize that Chapel Hill Tubal Reversal Center is the only facility where accuracy of information is considered a priority and sharing it with prospective patients is considered a necessity. Providing facts, rather than offering misleading or speculative statements about tubal reversal success, is one mission of our practice. We believe this is the right thing to do.
Tags: chapel hill tubal reversal center, mission statement, pregnancy announcements, pregnancy reports, pregnancy statistics, tubal reversal center, tubal reversal follow-up, tubal reversal information, tubal reversal patients, tubal reversal statistics
Posted in dr berger, pregnancy after tubal reversal, research | No Comments »
Saturday, December 1st, 2007
Tubal Ligation by Fimbriectomy
Fimbriectomy is an infrequent type of tubal ligation in the United States. This female sterilization method is performed by removing the fimbrial end of the fallopian tube. At the fimbrial end of the tube, the inner tubal lining faces outward towards the ovary. The tubal lining is rich in cilia that beat in coordinated waves to pull the egg into the tubal opening.
Many doctors think that tubal reversal cannot be successful following a fimbriectomy because of the loss of the egg-capturing fimbria. This is a mistaken notion. Cilia are abundant in the ampullary segment of the fallopian tube. The inner lining of the remaining ampullary tubal segment can be folded outward after opening the tube and can function as a new fimbrial end. The tubal reversal procedure for fimbriectomy reversal is called ampullary salpingostomy.
Fimbriectomy Reversal Pregnancy Rates
Chapel Hill Tubal Reversal Center publishes statistics updated annually regarding pregnancy rates and pregnancy outcomes for all of the women who have had tubal reversal procedures performed by Dr. Berger. The data for women who had tubal ligation procedures by fimbriectomy are from our Tubal Reversal Pregnancy Study Report 2007.
The overall pregnancy rate after fimbriectomy tubal reversal is 56% for patients at Chapel Hill Tubal Reversal Center. The following table shows the numbers and pregnancy rates according to womens’ ages at the time of their tubal reversal procedure.
Pregnancy Rates After Fimbriectomy Reversal
|
Age
|
All Women |
Pregnant (#) |
Pregnant (%) |
|
<30
|
29
|
20
|
69%
|
|
30-34
|
82
|
52
|
63%
|
|
35-39
|
131
|
81
|
62%
|
|
40+
|
70
|
22
|
31%
|
Recommendations for Fimbriectomy Reversal
The success of fimbriectomy reversal depends upon having an adequate length of ampullary segment of the fallopian tube. The length of the remaining ampullary tubal segment can be determined from a hysterosalpingogram (HSG) or from diagnostic laparoscopy.
I recommend having an HSG or choosing the screening laparoscopy option when tubal ligation has been performed by fimbriectomy. An HSG can be ordered by the patient’s local doctor and the x-ray films sent to me for examination prior to scheduling tubal reversal surgery. Alternatively, patients can omit having an HSG and schedule their reversal surgery to start with screening laparoscopy. This will show if ampullary salpingostomy will be effective. If so, the tubal reversal procedure will be performed at the same time while the patient is under anesthesia.
Tags: ampullary salpingostomy, fimbrae, fimbrial, fimbriectomies, fimbriectomy, fimbriectomy reversal, fimbriectomy tubal ligation, fimbriectomy tubal reversal, HSG, hysterosalpingogram, salpingostomy, screening laparoscopy option, tubal ligation, tubal reversal
Posted in pregnancy after tubal reversal, tubal ligation, tubal reversal procedure, tubal reversal surgery | No Comments »
Friday, November 30th, 2007
Tubal Ligation by Coagulation or Cauterization
Bipolar tubal coagulation is a popular method of female sterilization in the United States. This tubal ligation method is usually performed through laparoscopy. With the bipolar (two-poles) coagulator, the fallopian tube is grasped between two poles of electrical conducting forceps and electrical current is passed through the tube between the two ends of the forceps. Damage to the tube is limited mainly to the small segment between the forceps. Burning two or three adjacent sites is common and generally results in the loss of a few centimeters of the fallopian tube. Bipolar tubal cauterization can be successfully reversed in almost all cases.
Monopolar tubal coagulation is less common than bipolar coagulation tubal ligation. With monopolar forceps, electrical current spreads further along the length of the fallopian tube. Consequently, monopolar cautery tends to damage more of the fallopian tube than bipolar cautery. In many cases, the tube is also cut after it has been coagulated.
When monopolar coagulation is applied to a single site of the tube, tubal reversal can be performed without the need for further diagnostic tests. If multiple sites of the fallopian tube have been burned with the monopolar technique, we offer a screening diagnostic laparoscopy to evaluate the tubal lengths before proceeding to reparative surgery. The screening laparoscopy option is discussed further on our website.
Tubal Coagulation Reversal Success
Each year Chapel Hill Tubal Reversal Center publishes updated statistics about pregnancy rates and pregnancy outcomes among all of the women who have had tubal reversal procedures performed by Dr. Berger. The data for women who had tubal coagulation sterilizations, presented in the table below, are from our Tubal Reversal Pregnancy Study Report 2007.
Pregnancy Rates of Our Tubal Reversal Patients
The overall pregnancy rate after tubal reversal for women with tubal coagulation procedures is 68% for patients at Chapel Hill Tubal Reversal Center. To calculate the pregnancy rate, the number of women who have become pregnant is divided by the total number who underwent a tubal reversal procedure. The following table shows the numbers and pregnancy rates according to womens’ ages at the time of their tubal reversal surgery.
Pregnancy Rates After Tubal Coagulation Reversal
|
Age
|
All Women |
Pregnant (#) |
Pregnant (%) |
|
<30
|
168
|
142
|
85%
|
|
30-34
|
482
|
357
|
74%
|
|
35-39
|
408
|
260
|
64%
|
|
40+
|
130
|
46
|
35%
|
Conclusion
Tubal coagulation methods of tubal ligation can be successfully reversed in most cases. The pregnancy rate after tubal reversal varies with a woman’s age at the time she has her tubal reversal procedure. The pregnancy rate is 85% for women in their twenties, 74% for those ages 30-34, 64% for women in the 35-39 year age group, and 35% for women 40 years of age or older.
Tags: bipolar, burned tubes, chapel hill tubal reversal center, dr berger, fallopian tube, monopolar, pregnancy, pregnancy rates, tubal cauterization, tubal coagulation, tubal ligation, tubal ligation reversal, tubal reversal
Posted in pregnancy after tubal reversal, tubal reversal illustrations, tubal reversal procedure, tubal reversal surgery | 2 Comments »
Wednesday, November 28th, 2007
Tubal Ligation by Falope Ring and Hulka Clip
The Falope ring and Hulka clip are occlusive methods of tubal ligation. They block the fallopian tubes, but no tubal segments are clamped, removed, or burned. The Falope ring is also referred to as the tubal ring or tubal band. It constricts a segment of the fallopian tube very tightly, like an extra strong rubber band.
The Hulka clip is a miniature clamp placed across a very small (2-3 mm) segment of the fallopian tube. Another clip method besides the Hulka clip is the Filshie clip. The clips are similar except that the Hulka clip is made out of silastic and the Filshie clip is made out of metal. Occlusive methods of tubal ligation are predictably the best in terms of reversal since they damage such a tiny segment of the fallopian tube.
In contrast to the Pomeroy method, these occlusive devices are applied through a laparoscope. (Laparoscopy involves making a small incision below the belly button.) Many doctors prefer to apply tubal rings or clips when performing a tubal ligation on young women in recognition of the greater likelihood that a tubal reversal may be wanted in the future. Studies have shown that tubal ligation regret and the desire for tubal ligation reversal is more common when a tubal sterilization is performed among women in the twenties than among older women.
Tubal Clip and Ring Reversal Success
Each year Chapel Hill Tubal Reversal Center publishes current statistics about pregnancy rates and pregnancy outcomes among all of the women who have had tubal reversal procedures performed by Dr. Berger. The data for women who had tubal rings or clips shown in the table below is from our Tubal Reversal Pregnancy Study Report 2007.
Pregnancy Rates of Our Tubal Reversal Patients
The overall pregnancy rate after tubal reversal for women with clips or rings is 76% for patients at Chapel Hill Tubal Reversal Center. In the table below, the first column shows ages groups. The second column shows the number of women in each age group who had a tubal reversal. The third column shows the number of women in that group who became pregnant and the last column shows the percentage of women who became pregnant (the pregnancy rate) after their reversal procedures.
Pregnancy Rates After Tubal Reversal of Clips/Rings
|
Age
|
All Women |
Pregnant (#) |
Pregnant (%) |
|
<30
|
160
|
139
|
87%
|
|
30-34
|
318
|
265
|
83%
|
|
35-39
|
327
|
238
|
73%
|
|
40+
|
116
|
55
|
47%
|
Highest Pregnancy Rates After Tubal Reversal
The highest tubal reversal pregnancy rates are seen among women who have reversal of tubal clips or tubal rings. For women in their twenties, the pregnancy rate was 87%. The pregnancy rate ranged from 83% to 73% for women in their thirties. Among women age 40 or older, the pregnancy rate was significantly lower (47%), reflecting the decline in natural fertility with age. These pregnancy rates among our tubal reversal patients are similar to the pregnancy rates for women who have never had a tubal ligation to begin with.
Tags: age, dr berger, fallopian tube, falope ring, fertility, Hulka clip, pregnancy after tubal reversal, tubal bands, tubal clips, tubal ligation regret, tubal sterilization
Posted in pregnancy after tubal reversal, tubal ligation, tubal reversal illustrations, tubal reversal procedure, tubal reversal surgery | No Comments »
Tuesday, November 27th, 2007
Pomeroy Technique of Tubal Ligation and Resection
The most common type of tubal ligation is the Pomeroy procedure, named after Dr. Ralph Pomeroy who described it in 1930. The Pomeroy method involves picking up a segment of the fallopian tube to create a knuckle, placing a tie or ligature with absorbable suture around its base, and then cutting off the knuckle of tube above the tie. As the suture dissolves, the 2 remaining tubal segments separate from each other.
“Modified” Pomeroy Techniques
Interestingly, Dr. Pomeroy did not publish his technique in the medical literature but simply demonstrated it to other doctors. Some of them subsequently published the technique, but with modifications.
Currently, many doctors use the term modified Pomeroy procedure when they describe the tubal ligation they have performed in a patient’s operative report. Each doctor seems to have his or her own way of operating and there are many variations from the original method. Some doctors use absorbable suture, while others use permanent sutures that do not dissolve. Some doctors place more than one tie around the tube and many doctors also burn or cauterize the tubal ends.
A tubal ligation operative report is useful as a guide but does not predict exactly what the remaining tubal segments will be at the time of a reversal procedure. Fortunately, Pomeroy tubal ligation and its modifications are usually excellent in terms of reversibility.
Pomeroy Tubal Ligation Reversal Success
At Chapel Hill Tubal Reversal Center, we keep a record of all patients’ tubal reversal operations, including the tubal ligation method, the remaining tubal segment lengths, and other important findings at the time of surgery. Since we maintain long term follow-up with our patients, we are able to provide accurate statistics about pregnancies and their outcomes after tubal reversal surgery. Here are some of the pregnancy statistics for women who have had a Pomeroy type of tubal ligation.
Pregnancy Rates of Our Tubal Reversal Patients
The overall pregnancy rate after Pomeroy tubal ligation reversal is 70% for patients at Chapel Hill Tubal Reversal Center. The table below shows pregnancy rates according to women’s ages at the time of tubal reversal. The first column shows ages by 5 year groupings. The second column shows the number of women in each age group who had a tubal reversal. The third and fourth columns show the number and the percentage of women who became pregnant after their reversal procedure. The data shown in this table come from our Tubal Reversal Pregnancy Study Report 2007.
Here is how the pregnancy rate is calculated: The number of pregnant women (column 3) divided by all women in that age category who had reversal surgery (column 2) times 100 equals the percentage of women who became pregnant (column 4). A doctor has to know all of this information in order to be able to state what the success rate is for his patients.
Pregnancy Rate By Age After Pomeroy Tubal Reversal
|
Age
|
All Women
|
Pregnant (#)
|
Pregnant (%)
|
|
<30
|
201
|
159
|
79%
|
|
30-34
|
614
|
456
|
74%
|
|
35-39
|
599
|
399
|
67%
|
|
40+
|
190
|
84
|
44%
|
Good News About Pomeroy Reversal
The good news is that for women under age 40, two-thirds to four-fifths will become pregnant following a tubal reversal procedure. Even for women age 40 and over, approximately 4 out of 10 will conceive another pregnancy. From the follow-up data that we have for our tubal reversal patients, there is good reason for optimism when reversing a Pomeroy tubal ligation.
Tags: Dr. Ralph Pomeroy, fallopian tubes, Pomeroy tubal ligation, pregnancy after tubal reversal, pregnancy rates, tied tubes, tubal ligation reversal, tubal reversal
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