Tubal Reversal Blog ‘children’

If a woman has had her tubes tied (tubal ligation) and wants to have more children, then she has three options:

Adoption
In Vitro Fertilization (IVF)
Tubal Ligation Reversal

The blog article is part of a series of articles about tubal reversal after age 40. The first of this series is Tubal Ligation Reversal After the Age of 40| Introduction.

Read the rest of this article and comment on it. »

Susan is an international patient who traveled to Chapel Hill Tubal Reversal Center from Dubai, United Arab Emirates (UAE) for both tubal ligation reversal and ovarian conserving surgery. The day before her reversal surgery Susan and her partner, Stephen, sat with Dr. Monteith for a pre-operative interview. They have a unique story and we asked if they would allow us to share their story with our Tubal Reversal Blog and Tubal Reversal Message Board readers.

Read the rest of this article and comment on it. »

Women come from all over the world to Chapel Hill Tubal Reversal Center for reversing tied tubes – or more correctly put in medical terms, to have a tubal anastomosis. The majority of our patients desire sterilization reversal so they may naturally conceive more children. Many others, however, have ligation reversals to feel more complete again and/or to alleviate symptoms that have occurred after their surgical sterilization procedure. These patients report new physical and psychological symptoms after undergoing tubal ligation – symptoms that have been described as Post Tubal Ligation Syndrome (PTLS).

Symptoms of Post Tubal Ligation Syndrome

There are many symptoms attributable to PTLS. The most predominant symptoms are:

• Menstrual pattern changes
• Painful periods
• Hot flashes
• Irritability
• Mood swings
• Insomnia
• Decreased sex drive
• Anxiety
• Depression
• Memory changes

Does PTLS really exist?

The existence of Post Tubal Ligation Syndrome has been very controversial within the medical community. Early medical studies suggested that some sterilized women (women who had their tubes tied) had abrupt changes in bodily symptoms after their surgical procedures. These physical and mental changes were called Post Tubal Ligation Syndrome.

PTLS has been widely talked about by both women and medical professionals. Currently, PTLS information, advice, and ‘expert’ commentary saturate the internet. Conspiracy theories are prominent. Some people even believe sterilization is being forced upon women and there is a conspiracy, or lack of serious medical counseling, regarding the symptoms of PTLS.

More recent medical research has demonstrated that women do have changes in their menstrual patterns after tubal ligation; however, these changes are not as dramatic or as widespread as have been suggested in the past.

Observations from the Tubal Reversal Center

The tubal ligation reversal experts at Chapel Hill Tubal Reversal Center provide sterilization reversal to a large number of women from across the world. We also counsel and treat a substantial number of women who attribute their worsening menstrual patterns to their tubal ligation procedures. These patients report a multitude of PTLS symptoms.

We like for our patients to be well-informed. Since women seeking relief of PTLS represent an increasing percentage of the patient population we care for, we would like to dedicate a series of informative blog articles discussing the concept of PTLS. More specifically, we would like to discuss the common medical reasons for new symptoms noticed after tubal ligation, current understanding about PTLS, and common psychological conditions which can mimic PTLS.

This is article first of a fourteen part series. Our second article in this series is Post Tubal Ligation Syndrome: Past and Present.

Readers can also view patient submitted stories about their menstrual symptoms, reasons for reversing tubal ligation, and outcomes after reversal reversal surgery. Each patient’s story is listed below:

Meet Momzilla
Meet Andrea
Meet Rebecca
Meet Praybelieving
Meet Katherine

We invite readers to join the Tubal Reversal Message Board to discuss and share their personal experiences with tubal ligation. Feel free to contribute to our PTLS forum dedicated to patients who have personal insight into worsening symptoms after undergoing tubal ligation.

Editorial Comment

The decision to add a series of articles about Post Tubal Ligation Syndrome on the Tubal Reversal Blog was prompted by requests and suggestions of many of our tubal reversal patients. Most doctors have been taught that no such entity as PTLS exists, much to the exasperation of women who are suffering from symptoms that began after a tubal sterilization. This series of blog articles will allow individuals to report about their personal experiences and case histories. Then, articles from the medical literature will be reviewed and discussed. Hopefully, this approach will help explain the discrepancy between what individual women have experienced and what medical doctors think about this complex subject. I encourage both patients and medical professionals to contribute their insights and opinions to this important series of articles.

Gary S. Berger, MD
Medical Director
Chapel Hill Tubal Reversal Center

My First Day at Nourishing Hopes and Dreams

My first day as a tubal ligation reversal specialist will always be remembered. I began my training with Dr. Berger during the first week of January 2008. We started the day off by meeting the patients who would be undergoing tubal ligation reversal at Chapel Hill Tubal Reversal Center. I met four patients of different ages, backgrounds, and ethnicities . They were all very different people who all desired the same thing: reversal of their tubal ligation.

• The first patient was in her forties, she had emigrated from Ethiopia, her last child was more than twelve years ago, and she desired a chance to have another child.
• The second patient was in her thirties and her previous husband had died unexpectedly. She had children but her fiancé did not have any children. Together, they desired a child.
• The third patient,in her late twenties, had two children and a tubal ligation. Several years later she subsequently found a new partner and he desired a child with her. So while he was deployed overseas, she came for a tubal ligation and a chance for a new future when he returned from his military deployment.
• The fourth patient was in her late twenties and had several children. When she and her partner were in their early twenties they were financially maxed out and she had her tubes tied as an act of desperation. Several years later, she and her husband subsequently became financially stable and they wanted another child. They considered IVF but decided that a reversal was a better option for them. We also learned of an extremely sad story from this patient. She had a friend who had a tubal ligation. This friend had all of her four children die overnight in a house fire. This friend desperately has hope for a future reversal of her tubal ligation and was hoping to obtain a tubal reversal in the future.

All of the tubal reversal surgeries went well that day. The patients all did well and had technically excellent tubotubal reanastamosis (tubal ligation reversal) procedures. They all recovered well and went home to pursue their quest to add to their families. For as long as a live, I will never be able to forget these women, their partners and the stories they told. I can never forget their quest to add children to their lives. For them I hope they attain what they desire. My first lesson as a Tubal Reversal Specialist was that no one can predict the future, but if you always look hard enough you can always find a way – and someone to help- to correct prior mistakes.

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.