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.

New patients may want to learn about the relationship between Chapel Hill Tubal Reversal Center and Chapel Hill Surgical Center. They are interrelated health care organizations exclusively for the benefit of patients undergoing tubal reversal surgery.

Chapel Hill Tubal Reversal Center

Chapel Hill Tubal Reversal Center is the name of my private practice. It is located on the second floor of a 2 story building at 109 Conner Drive in Chapel Hill, North Carolina. Prior to 1997, Chapel Hill Tubal Reversal Center was known as Chapel Hill Fertility Center. During earlier years, complete diagnostic and treatment services were provided for all causes of infertility. Because it has always been my primary interest and special skill, I decided to limit my practice to tubal reparative surgery. I am the the only reproductive surgeon who performs tubal reversal surgery exclusively.

Chapel Hill Surgical Center

Chapel Hill Surgical Center is a licensed ambulatory surgical facility that occupies the first floor of 109 Conner Drive in Chapel Hill. This is where the tubal reversal procedures are performed. The facility has 3 operating rooms, a two-stage recovery room, and is staffed by a team of anesthesiologists, a nurse anesthetist, operating room nurses, recovery room nurses, surgical technologists, and an administrative staff. In the past, it was operated as a general ambulatory surgical center that included other doctors from many other surgical specialties. The facility was reorganized to provide tubal reconstructive surgery alone to allow all of the professional staff to concentrate on tubal reversal patients. This has led to the best medical care for women having a tubal reversal procedure.

A Unique Medical Organization

As the Medical Director of both facilities, I am assisted by a dedicated and highly trained staff of over 20 people who devote all of their efforts to caring for 4 couples a day having tubal reversal surgery. The staff to patient ratio (5:1) is higher than found in any other surgical center or hospital. This permits the most attentive and personalized medical care possible. There is no other medical organization like this anywhere else. Most patients learn about us from the Chapel Hill Tubal Reversal Center website, while others are referred by their doctors or previous patients. Couples come here from all 50 states in the US and from every continent around the world.

Our Mission

We take pride in being the premier medical facility for tubal ligation reversal. Our mission for 2008 is to restore hope, fertility, and the opportunity to have children for 800 more couples, as we have done each year in the past.

Patient’s History

Ana G. was one of the 4 patients I operated on today at Chapel Hill Tubal Reversal Center. She is a 28 year old woman from Angola, the mother of 3 children - ages 9, 8, and 6. She married when she was 15 and was in an abusive marriage. To keep from becoming pregnant again, she had a tubal ligation. When she had this done, all she could think about was not becoming pregnant again.

Ana eventually ran away and divorced her husband. Several years later she met a man who she fell in love with and who has treated her very well. He has no children. Now remarried, Ana feels that her second husband will want children in the future, so she decided to have a tubal ligation reversal. Although she doesn’t intend to become pregnant soon, she says that if it happens that would be fine.

Ana’s Tubal Reversal Procedure

Ana’s tubal reversal was performed by the technique of tubotubal anastomosis. Her fallopian tubes were in excellent health, with no fibrosis and with normal fimbriae and tubal endothelium. The anastomoses were isthmic-ampullary on the right and isthmic-isthmic anastomosis on the left. The tubal lengths after repair were 6.5 cm on the right and 8 cm on the left side.

Dr. Berger’s Comments

Every patient who comes to Chapel Hill Tubal Reversal Center has a unique story to tell that led up to the decision for a tubal reversal procedure. Divorce and remarriage is a common theme, and a history of abuse in the prior marriage is often one of the reasons given for the divorce.

Ana’s story is unusual in that she married at age 15 and had her tubal ligation by age 21. This may be due to the cultural differences in some African countries from the US. Although most of our patients come from the United States, couples come from many other countries to have me perform their tubal reversal surgery.

Although Ana’s operative report stated that Filshie clips had been applied to her tubes, no clips were found during surgery. It is not clear whether the operative report was incorrect, or whether the clips migrated to other locations in the abdominal cavity. This can occur if the pressure from the closed clips causes necrosis or death of the tissue within the clip. I have seen this occasionally in other patients.

Predicted Outcome After Ana’s Tubal Reversal

Based on her age and tubal lengths, Ana’s probability of becoming pregnant is 90% as documented in the post tubal reversal pregnancy statistics among patients at Chapel Hill Tubal Reversal Center.

Tubal Anastomosis at the Uterine Cornua

Tubouterine anastomosis is a tubal reversal procedure that is intermediate between tubotubal anastomosis and tubouterine implantation. It is also called cornual anastomosis because the tube is joined to the cornual area of the uterus with this operation. The cornu is the area where the fallopian tube normally emerges from the the uterus.

When Is Tubouterine Anastomosis Performed?

Tubouterine anastomosis is performed when there is a healthy tubal segment near the ovary, but no segment remains attached to the uterus, following a tubal ligation procedure. It is also performed when a tubal segment attached to the uterus is scarred and has no open lumen.

An incision is made into the uterus at the cornu to find the opening of the fallopian tube tube as it passes through the uterine muscle. If an opening is found, the tubal segment that remains is rejoined to the uterus at this site.

Case Histories

The topic of tubouterine anastomosis is a timely one. During the past week, 2 patients undergoing tubal reversal surgery at Chapel Hill Tubal Reversal Center required this operative procedure. In one case, each fallopian tube had been coagulated or burned next to the uterine cornu, leaving no segment attached to the uterus. The other patient had developed the condition known as salpingitis isthmica nodosa in the portion of the fallopian tube between the uterus and the a Falope ring. In both cases, tubal reversal was able to performed with the technique of tubouterine anastomosis.

Dr. Berger’s Comment

Frequently, patients have been informed by doctors who are not specialists in tubal ligation reversal that their fallopian tubes cannot be repaired after a tubal ligation. This is especially true when the proximal segments of the fallopian tubes are missing or diseased. But there are a variety of surgical techniques that can be used during tubal reversal surgery by a doctor who is an experienced tubal reversal surgeon. This is one of the advantages patients have when they come to Chapel Hill Tubal Reversal Center for their tubal reversal procedures.

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.

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.

Tubal Ligation Operations Vary

Tubal ligation operations vary in the amount of damage they cause to the fallopian tubes. Tubal coagulation (cauterization) tends to damage more of the tube than tubal ligation and resection or tubal clips/rings. Burning or cauterizing the fallopian tubes with a monopolar coagulator is more destructive than with a bipolar coagulator. With either type of coagulator, the more times the tube is burned, the greater the amount of damage that occurs.

How Much Fallopian Tube Remains After a Tubal Ligation?

The remaining amount and condition of the fallopian tubes after tubal ligation procedures varies a great deal. A patient’s tubal ligation operative report will give an indication about the remaining tubal segments that can be repaired by a tubal reversal procedure. When available, Dr. Berger always reviews the operative reports that are sent by patients to estimate the likely outcome from a tubal reversal operation.

In most cases, the tubal ligation operative report (and a pathology report if available) will help to determine if tubal reversal is possible. Until the time of surgery, the actual condition of the fallopian tubes remains unknown. This is partly because doctors differ in how they perform tubal ligation operations. With tubal coagulation procedures, for example, the coagulator can be used at different power settings and applied for varying lengths of time to the fallopian tubes. These details usually are not specified in an operative report.

Examining the Fallopian Tubes by Laparoscopy

Laparoscopy is a surgical procedure that permits viewing the fallopian tubes through a narrow telescope placed through a small incision below the belly button into the abdominal cavity. Laparoscopy can be performed for patients who want to be assured that tubal reversal is possible.

Laparoscopy is recommended in cases where the amount of tube remaining is questionable, such as after monopolar coagulation of multiple sites along the fallopian tube.

Dr. Berger performs laparoscopy under anesthesia and proceeds directly to tubal reversal, if examination shows the tubes are repairable. The patient is under anesthesia only one time. For safety reasons, screening laparoscopy is offered only to patients with a body mass index (BMI) of less than 30.

Screening Laparoscopy Cost

The additional charge for laparoscopy is $1000. If tubal reversal is not possible, the operation will end and you will receive a refund of close to 50% of the total surgery fee. The screening laparoscopy option is similar to an insurance policy. You purchase it and hope you never need it, but it is certainly nice if you do. Most patients do not elect to have the laparoscopic examination because of its additional cost and the knowledge that Dr. Berger can repair the fallopian tubes in 98% of cases, regardless of the method of tubal ligation.

People like knowing what to expect when they come to Chapel Hill Tubal Reversal Center for their tubal reversal procedure by reproductive surgeon Dr. Gary Berger, our Medical Director.

We provide a great deal of information about this on our website, in emails and letters, and by telephone.

Learn From Others on the Tubal Reversal Message Board

Another useful source of information about what to expect is the Tubal Reversal Message Board. Through the message board, women can ask questions and get responses from Dr. Berger’s staff and from others who have had their tubal reversal procedure. A message board member recently asked this question about what to expect in the Preparing for Tubal Reversal forum with the subject heading Need Details About Consultation:

“Can someone who has already had their consultation give me details about what happens at the consultation? I’m nervous ):”

She received this detailed reply from another board member:

“My wife had her tubal reversal just this week, so it is still pretty fresh for us. We went there on Monday, so the schedule of things may be different on other days.

She was very nervous; we drove down - an eleven hour drive - not sure what to expect. While there are countless messages on the board detailing great experiences, the fear of showing up and discovering either a second-rate facility or a scam were still in the back of our minds. She was also nervous about “making weight”, even though she was not even close to the BMI cutoff; my dear wife likes to fret over everything.

We met the shuttle van at the lobby of the Sheraton at 6:45; Doctor Berger’s facility is only 5 minutes down the road. When we pulled in, the courtyard gate was unlocked and open. We made our way up the stairs to the second floor, and the receptionist was ready and waiting; the waiting room up there looks like a very cozy, large, well appointed living room.

My wife got the luck of the draw and was first, so it was a very efficient, streamlined process. First up was blood pressure, height and weight. All went well, and we immediately met with Doctor Berger. He is professional, courteous, and yes, asked why we chose this. He didn’t seem judgmental about age or weight; he seemed genuinely committed to giving my wife back her reproductive rights to the best of his ability.

After that was the vaginal ultrasound. My wife preferred for me to be present; it was about 10 minutes total, minimally invasive, and yes, the nurse fine tuned the hair line for surgery.

We were immediately escorted downstairs to the surgery reception, and we were quickly greeted by one of the surgical nurses. I believe we had some very brief paperwork at that point, but we moved so efficiently, I could be wrong. We were escorted to the surgical waiting area, where she changed into a johnny and a robe, and answered some of the standard surgical questions.

My wife is no fan of needles, and we let the nurse know that previous IV experiences weren’t very good. When the nurse had trouble with the IV, she immediately called in one of the OR nurses who took over and inserted a new IV in one quick, painless hit.

They talked us through every single step, and soon, my wife was walking in to surgery. She says she climbed onto the table and doesn’t remember a darned thing until waking up! As she was waking up, the nurse went over post-op care with me in painstaking detail. What the meds are for, when to give them, what existing meds can be taken with them, etc. It was thorough, and I felt quite capable of caring for my wife when we returned to the hotel. When she was awake and lucid, and had successfully emptied her bladder, they allowed her to dress, and called for the Hotel Shuttle. 5 minutes later, it arrived, and we were back in our hotel room before 11am!

The next morning promptly at 7 am, the nurse visited our hotel room, inspected the incision, and took every bit of time we needed to feel comfortable for our trip home.

A few tips:

• An important detail is that Doctor Berger’s facility is amazingly efficient; while you don’t feel rushed, you are done before you know it. They have fine tuned the process so very little time is wasted.

• Stick to the medicine schedule! Don’t be a hero and skip your pain meds or you will regret it. My wife had a few bouts of soreness that would have been difficult in the days after surgery without meds.

• The nurses are all wonderful people; we enjoyed meeting them and letting them take care of my wife. Let them take care of you, and you will do fine.”

Support Before, During, and After Tubal Reversal

At Chapel Hill Tubal Reversal Center, our relationship with patients does not begin and end on the date of surgery.  When you choose Dr. Berger as your tubal reversal doctor, you can expect to have our support before, during, and after surgery.  We are available 24 hours a day, 7 days a week to answer questions and to provide education and information about the tubal reversal process.  Our goal is to provide you with all of the tools you will need on your tubal reversal journey.

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

Chapel Hill Tubal Reversal Center Anesthesia Team

The Anesthesia Team at Chapel Hill Tubal Reversal Center ensures your comfort before, during, and after your tubal reversal procedure. We are Caryn Hertz, MD, Pamella Mills, CRNA, and Ann Pflugrath, MD. Our team consists of two board certified anesthesiologists and a registered nurse anesthetist specializing in outpatient anesthesia. Our experience working every day with Dr. Berger results in the best care for each tubal reversal patient.

Ensuring Patient Safety

We assess the patient’s medical history even before they come to Chapel Hill Tubal Reversal Center. We speak with each patient by phone several weeks before their scheduled tubal reversal procedure. Most patients have just the basic preoperative lab tests. Some patients with medical conditions require additional tests. All of the preoperative lab work is done in the patient’s hometown, with the results being faxed to us for review. Each patient is sent written instructions of what to expect when they arrive at Chapel Hill Tubal Reversal Center.

On the day of your preoperative consultation with Dr. Berger, we will meet with you to review your medical history again. We will discuss instructions for the evening before surgery, such as about diet or other restrictions to follow to make sure you understand them. The day of surgery is less stressful for our patients because they have met our staff and have a full understanding of what to expect.

Ensuring Patient Comfort

Tubal reversal surgery by Dr. Berger is short. You will be asleep with “general” anesthesia during the 60-90 minute procedure. We work closely with Dr. Berger to assure excellent pain control after you awake from the operation. Dr. Berger injects local anesthesia into the muscles and surrounding tissues during tubal reversal surgery. This reduces the amount of anesthesia during surgery and the need for postoperative pain medication. Our postoperative focus is on nausea and pain control. Patients are discharged from the recovery room when they are comfortable, usually within one or two hours, and they are taken to their room at the Sheraton Hotel.

We Want You To Have The Best Medical Care Ever

We are fortunate at our day surgery center to have state of the art equipment with which we carefully monitor over 15 parameters during and after the tubal reversal procedure. We follow-up with all of our patients and review the evaluation forms that they complete when they have recovered. We pay special attention to any comments patients offer. Our goal is to keep tubal reversal surgery at Chapel Hill Tubal Reversal Center safe, comfortable, and the best medical experience our patients have ever had!