Exchanging Information About Tubal Reversal

The Tubal Reversal Message Board is provided by Chapel Hill Tubal Reversal Center to allow women to communicate with each other about tubal ligation reversal. Members of Dr. Berger’s staff also contribute their insights in the message posts. Here is an example of how members help and support each other on the message board in response to a post by a new member. There are many abbreviations members use in their posts. These are explained on our website page Message Board Abbreviations.

Hello, my name Heather Jo and I live in Southern Oregon. I am 28 and already have three great kids - Chris 14, Emily 7 and Bradley 5. I am getting married on 2/29/08 to my soon to be DH Justin (who has no children yet). I had my TL on 5/9/02 after the birth of my youngest son. I hope to have more babies after my TR, which we hope to have done by the end of summer 08. I look forward to being on here and having my questions answered.

Welcome Heather Jo! We look forward to seeing you in the future. Don’t hesitate to ask any questions.    Lori RN

Welcome Heather Jo! You are in the right place to have your TR done!! Dr. Berger and the Staff at Chapel Hill Tubal Reversal Center are the best.    Veronica

Nice to meet you Heather Jo. I wish you all the best.
ME-27
DH-21
DS-7
DD-4
TL-10/20/03
TR- shooting for March of 2008    Miranda

Hi, Heather! I hope that all goes well. We are all embarking on a wonderful journey! I am also new and am on the board looking for answers, comfort and support. Take Care,     Cora

Welcome to the board, Heather Jo! Congratulations on your upcoming wedding. Let me know if you need assistance with the scheduling process. Feel free to ask all the quetions you have….we are all family and the Tr sisters are great at answering questions or just making you feel welcomed.     Ericka Pamplin

Thank You for the warm welcomes. I am a little scared about the whole TR surgery. I know in my heart that I want more children. I know I’m not “done” yet. But being put under and the actual surgery scares me. I know it is worth it, and that’s why I try not to think about all that stuff. I already had my post op report sent to Dr Berger back in 2005, so this has been a couple years in the making for me. I hope to be on the post TR side of things by this time next year! Well again, THANK YOU and best wishes!    Heather Jo

It’s normal to be scared…I think we are all a little scared about the surgery and about what happens next. I’m more terrified of not conceiving than the actual surgery. I know that Dr. Berger and his staff will take excellent care of me. It’s what I have to do on my own that haunts me!!! Good luck,    Cora

Heather- I was scared about getting the TR done. Not just the surgery but everything that went with this major decision. But I am so glad that I did…I had my TR 11/19/07 and I just found out that we are pregnant! We couldn’t be more thrilled!    Jenn
TR-11/19/07
BFP-12/30/07

Congratulations. That means a lot to hear about someone having a BFP so soon after their TR. Please keep me updated! TR: March/April…I hope.    Cora

Heather Jo - Hi! My name is Jeannine. I live in Salem, OR and just had my TR last month. It was a great experience. Even my DH had nothing but good things to say about our trip, Dr. Berger and his staff and the whole surgical process. It is worth traveling across the country to do! Good luck with your journey.    Jeannine
TL 4-28-01
TR 11-16-07

It does help to hear about others having a great trip when they got their TR. I am hoping for one in March of 2008.    Miranda

CONGRATS ON BFP! Im so excited for you! I think I am going to lose my mind in this process. I know that I want this done but it seems like I’m trying to convince everyone else around me why I should. A lot of people think that it will be a big waste of money especially since I have had my tubes cut, tied, and burned. I’m sure that I’m not the only person who has had this done and that there are plenty of women who have gotten a BFP after reversing this type of TL. I’m going to plan on the end of this year for my TR. How do you send your reports to CH? What do I send exactly? You gals are great supporters by the way.   Patiently Waiting
ME-27
DH-34
DS-4
DS-3
TL-12/04

I went to the hospital where they did my TL and got a copy of what they did and then my mom faxed it over to CH. It is that easy. Some hospitals will fax it for you if you take and print out the CH release form and take it with you so they know where to send it. It does not take long before you hear back from them with where you stand. I hope this helps. I got the ok from CH. I am going to set my TR up for March 08. Hope to hear how things go with you.    Miranda

Dr. Berger’s staff is great about reviewing your records and getting back with you on your chances for success. They won’t tell you to go ahead with it if there’s no chance of a BFP.   Cora

Welcome Heather- you have made the best decision with Dr Berger. He is truly a blessing and a miracle worker. We are all for you. My surgery was quick- I was in and out of CHTRC in a matter of hours. Good luck with your upcoming marriage.   Melissa
Me: 38
TL: 10/97
TR: 1/12/06
BFP: 2/12/06
EDD: 10/25/06
DS, Brady, our miracle baby, born 10/21/06
8 pounds, 5.8 ounces
21 inches long

Thanks Miranda and Cora - you ladies have been a Godsend. I really appreciate it. I have 2 DS by my husband already but I don’t know why I stopped at 2, plus this PTLS is causing a lot of problems. I can’t wait to have this TR done.   Patiently Waiting

Patiently Waiting ~ I know what you mean…PTLS is cruel. I had said before that my husband keeps mentioning “how I used to be”…but I always strugged it off to him just being a man and us evolving. But, after hearing all the stories from other women, I am beginning to believe that I am suffering from it as well! I hope for a smooth surgery with lots of luck in March/April. I wish you all the best, too.   Cora

I have been wanting to have a TR for about 5 years now. I have 2 boys from a previous relationship and my husband has no children (well, he claims mine and treats them as his) I have talked about TR for years and my husband would never seem interested and then sometimes he would and I would get so frustrated with him thinking he just didn’t want kids with me. He finally started coming around and told me that he was scared and that he wanted to get financially stable before we had the surgery and tried to bring a new baby into the home. So, now I am closer than ever and our intentions are to schedule in March or April this year. I am working on my weight loss now as I have to lose 20 lbs to be under BMI for surgery. I know I can do it within the next 3-4 months and I am trying hard so I can have my TR and start TTC!!!!   Stephcave

Dr. Berger’s Comment

This excerpt is a good example of how women support and inform each other on the Tubal Reversal Message Board regardless of where they are from. Many women might feel they are alone in their desire to have another baby after a previous tubal ligation, but when they participate in the message board they realize that they are not alone at all.

At Chapel Hill Tubal Reversal Center, we receive requests 7 days a week, 365 days a year, for information about tubal ligation reversal. These requests come from women who regret having a tubal ligation. A staff member recently asked me how big a problem this is throughout the country. The following is in response to this question.

How Many Women Have Had A Tubal Ligation?

There is no single data source reporting the number of surgical sterilizations performed in the United States. Based on multiple sources of information, it is likely that 650,000 to 700,000 tubal sterilizations are performed each year, and more than 11 million American women have had a sterilization operation. The latest study, conducted in 2002 by the US Department of Health and Human Services, indicates that between one in four to one in five of adult, sexually active women have had a tubal ligation.⁽¹⁾

How Common Is Tubal Ligation Regret?

Many factors can affect a woman’s likelihood to regret sterilization. Among women who had a tubal ligation, risk factors for regret include young age, less education, and a husband or partner who wanted the woman to have a tubal ligation.

In 1999, a study called the Collaborative Review of Sterilization (CREST) found that 20% of women who were sterilized before the age of 30 regretted their decision. Women who were sterilized at a young age had a higher chance of requesting information about reversal, regardless of their number of living children. Also, women who reported conflict with their husbands or partners before tubal sterilization were more than three times as likely to regret their decision and more than five times as likely to request a reversal than women who did not report such conflict. ⁽²⁾

Dr. Berger’s Comment

This statistical information helps give a broader picture to the significance of the issues and comments raised in the previous blog topic - Ethics of Tubal Ligation. Additional comments on this issue are welcome from all readers.

References

1. MMWR Surveillance Summary, “Contraceptive Use — United States and Territories, Behavioral Risk Factor Surveillance System, 2002.
2. Mosher WD, Martinez GM, Chandra A, Abma JC, Wilson SJ. Use of contraception and use of family planning services in the United States: 1982–2002. Hyattsville, MD: US Department of Health and Human Services, National Center for Health Statistics, 2004. Advance Data from Vital and Health: no. 350.

Salpingitis Isthmica Nodosa

Salpingitis isthmica nodosa is a nodular swelling of the isthmic segment of the fallopian tube. This fallopian tube abnormality is sometimes encountered at the time of tubal reversal surgery. It often involves the interstitial portion of tube that is within the uterine muscle. The nodule is due to thickening of the muscular wall of the tube around ingrowths or projections of the inner mucus membrane tubal layer into the muscle.

History of Salpingitis Isthmica Nodosa: Scholarly Publications

This tubal abnormality was first described and named by Chiari in 1887 .⁽¹⁾ The name he gave it reflected his belief this was an inflammatory condition. (Salpingitis means inflammation of the fallopian tube.) His contemporary, Kossman, also thought this was an inflammatory condition.⁽²⁾ An alternate theory of causation was suggested by Recklinghausen in 1896 who believed it to be a congenital abnormality.⁽³⁾ A third possibility, suggested by Benjamin and Beaver in 1951, is that SIN is an acquired, noninflammatory condition.⁽⁴⁾ They believed that the lesion begins as an overgrowth of the inner tubal lining that penetrates into the tubal muscular wall. Then cysts form and the tubal muscular wall becomes enlarged and fibrotic. This has also been termed endosalpingosis, a condition closely related to uterine adenomyosis (a form of endometriosis in which the uterine endometrium grows into the uterine muscle).

HSG Diagnostic Findings

Salpingitis isthmica nodosa can be diagnosed radiographically. A hysterosalpingogram or HSG shows multiple small diverticuli or outpouchings of of x-ray dye protruding from the tubal lumen into the wall of the isthmic portion of the fallopian tubes. Because of its appearance at HSG, radiologists call it tubal diverticulosis.⁽⁵⁾

Clinical Implications

Salpingitis isthmica nodosa is associated with increased rates of infertility by interfering with upward sperm migration and ectopic pregnancy by trapping the fertilized egg within the tube.

Treatment During Tubal Reversal

Salpingitis isthmica nodosa may be encountered at the time of tubal reversal surgery. Because of the dense abnormality of the fallopian tube at its connection with the uterus, tubotubal anastomosis is not possible. In this situation, tubouterine anastomosis or tubouterine implantation can be performed.

Tubal Reversal Scholarly Publications

Early Experimental Studies in Animals

In 1969, David, Brackett and Garcia ⁽¹⁾ reported using microsurgical techniques for uterotubal anastomosis after removing the uterotubal junction from one side in 25 rabbits. Among 11 (44%) of the animals that became pregnant, fewer implantations occurred on the operated side than on the unoperated side. This showed that the uterotubal junction has a role, but is not absolutely required, in transferring embryos from the fallopian tube into the uterus for implantation.

In 1974, Paterson and Wood ⁽²⁾ divided the isthmic segment of one fallopian tube and then performed tubal anastomosis in 10 rabbits. They removed the fallopian tube and ovary on the other side so that any pregnancies that followed could be attributed to the repaired fallopian tube. The pregnancy rate was 60%. These investigators suggested that tubal anastomosis could be applied successfully to humans for reversal of tubal sterilization.

Hulka and Ulberg ⁽³⁾ in 1975 were the first to perform a successful reversal of tubal sterilization under experimental conditions. Six weeks after applying Hulka clips to the isthmic portion of fallopian tubes in 8 pigs, they removed the clipped portion of tubes and performed tubal anastomosis using an absorbable, multifilament suture (6-0 Dexon). Six (75%) of the animals subsequently became pregnant.

In 1975 Winston ⁽⁴⁾ reported an experiment in rabbits in which the experimental variables were different suture materials and duration of tubal splinting. In one group of 25 rabbits, he removed a portion of the tubal isthmus or ampulla and then performed tubotubal anastomosis with a nonabsorbable, nonreactive, monofilament suture (10-0 nylon). Using microsurgical technique, Winston took special care to include only the 2 outer layers (muscularis and serosa) of the fallopian tube in the suture line, avoiding the inner tubal layer (endothelium). He stabilized the anastomotic sites with polyethylene splints that were removed before closure of the abdominal cavity. Twenty-three (92%) of the animals became pregnant. This was the highest pregnancy rate reported so far after tubal anastomosis in animal studies. When either 8-0 catgut was used as the suture material or the tubal splint was left in place for 1 week after surgery, the pregnancy rate dropped in half.

Winston’s results were subsequently corroborated using microsurgical tubal anastomosis with 11-0 nylon, intraoperative splinting, and avoiding mucosal trauma from suture in the reconstruction of rabbit oviducts six weeks after application of Falope rings. Eighteen (82%) of 22 rabbits became pregnant after two matings.

Comment

Experimental studies in animals demonstrated excellent pregnancy rates following reconstruction of the fallopian tube by tubal anastomosis. They provided the basis for tubal reversal surgery as a clinical treatment. The best results came using microsurgical techniques with non-reactive, monofilament suture material, intraoperative tubal splints, and avoiding the introduction of suture in the inner layer of the tube.

Dr. Berger uses these surgical techniques in his tubal reversal procedures. For a more complete description of the early history of tubal reversal surgery, read Dr. Berger’s book chapter, Reversal of Female Sterilization: An Evaluation of Results ⁽⁵⁾.

References

1. David A, Brackett BG, Garcia CR: Effects of microsurgical removal of the rabbit uterotubal junction. Fertil Steril 20:250, 1969
2. Hulka JF, Ulberg LC: Reversibility of clip sterilization. Fertil Steril 26:1132, 1975
3. Paterson P, Wood C: The use of microsurgery in the reanastomosis of the rabbit fallopian tube. Fertil Steril 25:757, 1974
4. Winston RML: Microsurgical reanastomosis of the rabbit oviduct and its functional and pathological sequelae. Br I Obstet Gynaecol 82 :513, 1975
5. Berger GS: Reversal of female sterilization: An evaluation of results. In JM Phillips, editor, Microsurgery in Gynecology, Chapter 33. American Association of Gynecologic Laparoscopists, Downey, California, 238-243, 1977.

Gary S Berger MD, Medical Director of Chapel Hill Tubal Reversal Center, is well known for his contributions to clinical medicine as a reproductive surgeon. Patients sometimes ask about Dr. Berger’s education, training, academic credentials, scholarly research and publications.

This is a resume of Dr. Berger’s academic credentials:

ACADEMIC DEGREES

1965 A.B. with Honors
Harvard College
Boston, Massachusetts

1969 M.D.
University of Rochester
Rochester, New York

1976 M.S.P.H.
University of North Carolina
School of Public Health
Chapel Hill, North Carolina

POSTGRADUATE EDUCATION

1969 - 1970 Intern
Department of Internal Medicine
Duke University Hospital
Durham, North Carolina

1970 - 1971 Assistant Resident
Department of Gynecology and Obstetrics
Johns Hopkins Hospital
Baltimore, Maryland

1971 - 1973 Epidemic Intelligence Service Officer
Family Planning Evaluation Program
Bureau of Epidemiology
Centers for Disease Control
U.S. Public Health Service
Atlanta, Georgia

1973 - 1976 Resident
Department of Obstetrics and Gynecology
University of North Carolina
Chapel Hill, North Carolina

ACADEMIC APPOINTMENTS

1976 - 1979 Assistant Professor
Department of Obstetrics and Gynecology
University of North Carolina at Chapel Hill
Chapel Hill, NC

1980 - 2003 Adjunct Associate Professor
Department of Maternal and Child Health
School of Public Health
University of North Carolina at Chapel Hill
Chapel Hill, NC

1992 - 2003 Clinical Associate Professor
Department of Obstetrics and Gynecology
University of North Carolina
Chapel Hill, NC

SCHOLARLY PUBLICATIONS

Dr. Berger has published more than 160 peer-reviewed scientific articles in medical journals. He has also authored or edited these medical books:

D.A. Edelman, G.S. Berger and L.G. Keith. Intrauterine Devices and Their Complications. G.K. Hall, 1979.

L.G. Keith, M. Labbok, J. Petty, and G.S. Berger. Postpartum and Postabortal Contraception. Synapse Publications, 1979.

L.G. Keith, D.R. Kent, G.S. Berger, and J.R. Brittain, editors. The Safety of Feliility Control. Springer Publishing Company, 1980.

M. Jackson, G.S. Berger and L.G. Keith. Vaginal Contraception. G.K. Hall, 1980.

L.G. Keith, G.S. Berger and D.A. Edleman, editors. Infections in Reproductive Health: Common Infections. Vol. I, MTP Press Ltd., 1985.

L.G. Keith, G.S. Berger and D.A. Edelman, editors. Infections in Reproductive Health: Uncommon Infections and Special Topics. Vol. II, MTP Press, Ltd., 1986.

M. Bygdeman, G.S. Berger, L.G. Keith, editors. Prostaglandins and Their Inhibitors in Clinical Obstetrics and Gynecology. MTP Press, Ltd., 1986.

G.S. Berger, M. Goldstein and M. Fuerst. The Couple’s Guide to Fertility. Doubleday and Company, 1985.

G.S. Berger, L.V. Westrom, editors. Pelvic Inflammatory Disease. Raven Press, 1992.

C. Nezhat, G.S. Berger, V.C. Buttram, and F. Nezhat, editors. Endometriosis: Advanced Management and Surgical Techniques. Springer-Verlag, 1995.

G.S. Berger, M. Goldstein and M. Fuerst. The Couple’s Guide to Fertility, revised edition. Doubleday and Company, 1995.

G.S. Berger, M. Goldstein and M. Fuerst. The Couple’s Guide to Fertility: With the Newest Scientific Techniques to Help You Have a Baby. Broadway Books, 2001.

Dr. Berger - Clinician and Scholar

Dr. Berger’s contributions to reproductive medicine and surgery show that a clinician whose primary responsibility is in the care of individual patients can also be a scholar contributing to academic research. This is the basis of Dr. Berger’s ongoing Tubal Reversal Pregnancy Study that documents and analyzes the clinical outcomes of his patients following tubal reversal surgery.

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:

1. Post-operative nurse visit the morning after surgery;
2. Telephone follow-up on the second postoperative day;
3. Telephone follow-up on the third postoperative day;
4. E-mail questionnaire at two weeks;
5. Telephone contact at 6 months;
6. 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.

What is Essure?

Essure is a permanent birth control device that has recently become available as an alternative to traditional tubal ligation methods. The spring-like device is inserted through the uterine cavity into the tubal openings using a hysteroscope. This can be done as an in-office procedure. The device expands to fill the tubal opening and then becomes scarred into place, forming a barrier so that sperm cannot reach the egg. Because of the scar formation, it cannot be pulled out of the tube. It is advertised by the manufacturer as a permanent method of birth control. In this respect, it is similar to other tubal ligation methods that are considered by most doctors to be permanent.

Here is a link to an online video animation of the placement of the Essure device into the fallopian tubes.

Is Tubal Reversal Possible For The Essure Device?

I perform 4 tubal reversal procedures each day at Chapel Hill Tubal Reversal Center. The women who come here have all varieties of tubal ligation methods. Today, one of the patients had the Essure sterilization method. When she chose this form of tubal sterilization, she was unaware that she would become remarried and want to be able to try to have a child with her new husband.

Although I could not find any previous references regarding attempts to reverse the Essure procedure, I agreed to attempt to perform a reversal for her. The way I did this was to cut the device out of the uterine muscle and then implant the remaining fallopian tube into the uterine cavity through a new opening in the uterus. This procedure is called tubouterine implantation.

The reason I removed the device was that part of the metal spring projects into the uterine cavity. If a pregnancy were to occur with the device in place, this could be harmful to the pregnancy. To my knowledge, this is the first time that the Essure sterilization procedure has been reversed.

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

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.

The circumstances that lead people to have a tubal reversal procedure are unique to each person. Understanding them is helpful to me as a tubal reversal specialist providing their care during and after tubal reversal surgery.

Preoperative Consultation

When meeting new patients, I begin the preoperative consultation by asking about the circumstances that have them brought to me. After greeting patients and having them get settled comfortably in my office, I ask: What made you decide to have a tubal reversal at this time? Each person or couple responds in their own way to this nondirective question, often touching on their personal, social, and medical history that have brought them to this point in their lives. Their responses provide the context for the discussion that follows about their tubal reversal procedure.

Reasons for Tubal Reversal

The reasons given for having a tubal reversal vary. The most common one is that the patient is in, or about to enter, a new marriage. Often, the man has no biological children. Even when both partners have children from previous marriages, they want to establish a family of their own. Less commonly, couples who already have children together want to expand their family. For these couples, their past choice to have a tubal ligation is no longer the right decision for them. Sometimes they describe religious considerations, a change in financial stability, or tragically, the death of a child.

Tubal Ligation Regret

Many women have told me that they had a tubal ligation as a way out of a bad situation. Some did not want to have any more children while in a failing or abusive marriage. Others felt pressured into having their tubes tied by a parent, other family members, spouse, or even their doctor. Women who had their tubes tied while undergoing a C-section often report they made a hasty decision while in labor and almost immediately felt that it was a mistake.

Post Tubal Ligation Syndrome

An increasing number of women describe a variety of symptoms that started when they had their tubes tied. Most often these include heavy or painful periods, headaches, irritability, or other emotional reactions that were not present before their tubal sterilization. Many of these patients have been treated by their doctors with hormones, anti-depressants, or other medications to no avail and usually have been told that Post Tubal Ligation Syndrome does not exist. But they are convinced from their own histories that it does. A study that we are currently conducting finds that over 90% of these women report improvement or complete relief of their symptoms after tubal reversal surgery. Clearly, more research about this controversial subject is warranted.

Informed Consent and Patient Follow-up

Whatever the reasons for having a tubal reversal, it is important for patients to be fully informed about the potential benefits and risks of the operation. Equally important is the long term follow-up that we maintain with patients after surgery. This has enabled us to document and report the outcomes of tubal reversal surgery to a much greater extent than has ever been done before.

Chapel Hill Tubal Reversal Center

Chapel Hill Tubal Reversal Center is the only medical center exclusively for tubal ligation reversal. Patients travel from all over to have their tubal reversal procedures performed here. After surgery, each patient puts a pin in the map indicating where she is from. The map below shows that people come from all over the country. In fact, patients come here from all over the world.

Why Patients Come Here

Why are people willing to travel so far for a surgical procedure? They tell me it is to get the best outcome that is possible. Most patients have found out about us while doing research about tubal reversal surgery and doctors on the internet. Many have seen “The Operation“ on TV or the free video or dvd that we send out on request. This video gives a real couple’s perspective of the outpatient procedure and how well it works. When it comes to having a very much wanted baby, most people are willing to travel to get the best outcome.

What They Say About Us

To have an idea of what it is like to be one of our patients, read what previous patients have said about their experiences here. There are thousands of comments on various website pages such as About Us and Pregnancy Testimonials. Or visit an independent website such as RateMDs.com. Here are a few of the comments patients have made on this doctors rating site:

“Dr. Berger and his staff were awesome!!!! They were extremely kind and patient, very approachable, and every detail of my surgery and recovery were explained. I only needed pain medication the first night following my surgery and I was able to resume my normal activities the next day. I would highly recommend Dr. Berger to everyone considering tubal reversal surgery. God has granted him the power to make miracles happen.” Shelia TR 06/08/07

“The care I received from Dr. Berger was phenomenal. It was the most professional and compassionate medical experience I have ever had. The follow up care has been just as impressive even now, over a year and a half later. Dr. Berger is the best choice a couple could possibly make.” Julia and Kevin Disorda - Vermont

“Dr. Berger and his staff are just amazing, not only as people but at the work they do. I traveled from California to see Dr. Berger and could not be happier with my decision. I was so pleased with how fast my recovery was and that I had no pain after the surgery. Dr. Berger and staff are there for you whenever you need them, and will make you feel as if you are family.” Sharon Lincoln - California